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Abstract
ABSTRACT
Endoscopic Third Ventriculostomy (ETV) is a minimally invasive procedure that allows for fenestration of the third ventricle into the prepontine cistern. It is generally indicated for all forms of obstructive hydrocephalus. This technique has only recently been introduced at Laquintinie Hospital, and our study aimed to evaluate its use. From 2022 to 2023, we conducted a retrospective study of 23 ETV patients. CT scans were obtained for all patients, while MRI was performed only for those with tumors. In our study, out of the 23 enrolled patients, 22 were children. Regarding etiology, 73% of patients had congenital malformative obstructive hydrocephalus. The remaining 27% had brain tumors obstructing cerebrospinal fluid flow. The clinical presentation varied with respect to the age population. The failure rate of ETV was 17%. All patients with failures underwent reoperation via ventriculoperitoneal shunt. There were no major complications.
RÉSUMÉ
La ventriculocisternostomie est une procédure minimalement invasive permettant la fenestration du troisième ventricule dans la citerne prépontine. Elle est généralement indiquée pour toutes les formes d'hydrocéphalie obstructive. Cette technique a été récemment introduite à l'Hôpital Laquintinie, et notre étude visait à évaluer son utilisation. De 2022 à 2023, nous avons mené une étude rétrospective portant sur 23 patients ayant subi une ventriculocisternostomie. Des scanners cérébraux ont été réalisés pour l'ensemble des patients, tandis que des IRM n'ont été effectuées que pour les patients présentant des tumeurs cérébrales. Dans notre étude, sur les 23 patients inclus, 22 étaient des enfants. En ce qui concerne l'étiologie, 73 % des patients présentaient une hydrocéphalie obstructive d'origine malformative congénitale. Les 27 % restants avaient des tumeurs cérébrales obstruant la circulation du liquide céphalorachidien. La présentation clinique variait en fonction de la tranche d'âge de la population. Le taux d'échec de la ventriculocisternostomie était de 17 %. Tous les patients en échec ont été réopérés par une dérivation ventriculo-péritonéale. Aucune complication majeure n'a été relevée.
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References
- Van Beijnum J, Hanlo PW, Fischer K, Majidpour MM, Kortekaas MF, Verdaasdonk RM, et al. Laser-assisted endoscopic third ventriculostomy: Long-term results in a series of 202 patients. Neurosurgery 2008; 62:437- 43; discussion 443-4. 6.
- Mohanty A, Santosh V, Devi BI, Satish S, Biswas A. Efficacy of simultaneous single-trajectory endoscopic tumor biopsy and endoscopic cerebrospinal fluid diversion procedures in intra- and paraventricular tumors. Neurosurg Focus 2011;30: E4.
- Kadrian D, van Gelder J, Florida D, Jones R, Vonau M, Teo C, Stening W, Kwok B (2005) Long-term reliability of endoscopic third ventriculostomy. Neurosurgery 56 :1271–1278.
- Souare IS, Souare IS jr, Haidara A, Boubane DT, Bah AB, Diawara S, Béavogui K, Diallo LL. Hydrocéphalie chez l’enfant: résultats préliminaires d’une prise en charge multidisciplinaire en Guinée. Journal de Neurologie-Neurochirurgie-Psychiatrie (www.jnnp.fr) Vol. 002, N16, 2017 : 47– 53.
- Tabarki B, et al. Hydrocéphalies de l’enfant, aspects étiologiques et évolutifs à propos de 86 observations. Rev Maghreb Pédiatrie Mars – Avril. 2001 ; XI-II :65–70.
- Tortora G. Principe d’anatomie et de physiologie, l’encéphale et les nerfs crâniens ; 2ème édition française, 1994, p.420.
- Durnford AJ, Kirkham FJ, Mathad N, Sparrow OC (2011) Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus: validation of a success score that predicts long-term outcome.
- Chowdhry SA, Cohen AR: Intraventricular neuroendoscopy: complication avoidance and management. World Neurosurgery. 2012
- Mouafo Tambo, F. F.; Djientcheu, V.1; Chiabi, A.; Mbarnjuk, S. A.1; Walburga, Y. J.2; Mbonda, E.; Sosso, M. A. Our experience in the management of infantile hydrocephalus: A study on thirty-five regrouped cases in Yaounde, Cameroon. African Journal of Paediatric Surgery. 2011 ; 199-201
- Warf BC. Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a retrospective study in 500 African children. J Neurosurg. 2005; 103: 475-81.
- Oumar D, Mahamadou D, Landry K, Oumar C, Daouda S, Abdoulaye HM Endoscopic Third Ventriculostomy with choroid plexus cauterization in infantile hydrocephalus: An Experience from Mali. Pediatr Neurosurg: 2023; 58: 38-44
- Djientcheu VDP, Nguefack S, Mouafo TO, Mbarnjuk AS, Yamgoue Y et al Hydrocephalus in toddlers: the place of shunts in sub-Saharan African countries. Child’s Nervous system. 2001
- Adeloye A. Management of infantile hydrocephalus in central Africa. Trop Doct. 2001 ;31 :67–70.
- Marano PJ, Stone SSD, Mugamba J, Ssenyonga P, Warf EB, Warf BC. Reopening of an obstructed third ventriculostomy: long-term success and factors affecting outcome in 215 infants. J Neurosurg Pediatr 2015 ; 15 :399–405.
References
Van Beijnum J, Hanlo PW, Fischer K, Majidpour MM, Kortekaas MF, Verdaasdonk RM, et al. Laser-assisted endoscopic third ventriculostomy: Long-term results in a series of 202 patients. Neurosurgery 2008; 62:437- 43; discussion 443-4. 6.
Mohanty A, Santosh V, Devi BI, Satish S, Biswas A. Efficacy of simultaneous single-trajectory endoscopic tumor biopsy and endoscopic cerebrospinal fluid diversion procedures in intra- and paraventricular tumors. Neurosurg Focus 2011;30: E4.
Kadrian D, van Gelder J, Florida D, Jones R, Vonau M, Teo C, Stening W, Kwok B (2005) Long-term reliability of endoscopic third ventriculostomy. Neurosurgery 56 :1271–1278.
Souare IS, Souare IS jr, Haidara A, Boubane DT, Bah AB, Diawara S, Béavogui K, Diallo LL. Hydrocéphalie chez l’enfant: résultats préliminaires d’une prise en charge multidisciplinaire en Guinée. Journal de Neurologie-Neurochirurgie-Psychiatrie (www.jnnp.fr) Vol. 002, N16, 2017 : 47– 53.
Tabarki B, et al. Hydrocéphalies de l’enfant, aspects étiologiques et évolutifs à propos de 86 observations. Rev Maghreb Pédiatrie Mars – Avril. 2001 ; XI-II :65–70.
Tortora G. Principe d’anatomie et de physiologie, l’encéphale et les nerfs crâniens ; 2ème édition française, 1994, p.420.
Durnford AJ, Kirkham FJ, Mathad N, Sparrow OC (2011) Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus: validation of a success score that predicts long-term outcome.
Chowdhry SA, Cohen AR: Intraventricular neuroendoscopy: complication avoidance and management. World Neurosurgery. 2012
Mouafo Tambo, F. F.; Djientcheu, V.1; Chiabi, A.; Mbarnjuk, S. A.1; Walburga, Y. J.2; Mbonda, E.; Sosso, M. A. Our experience in the management of infantile hydrocephalus: A study on thirty-five regrouped cases in Yaounde, Cameroon. African Journal of Paediatric Surgery. 2011 ; 199-201
Warf BC. Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a retrospective study in 500 African children. J Neurosurg. 2005; 103: 475-81.
Oumar D, Mahamadou D, Landry K, Oumar C, Daouda S, Abdoulaye HM Endoscopic Third Ventriculostomy with choroid plexus cauterization in infantile hydrocephalus: An Experience from Mali. Pediatr Neurosurg: 2023; 58: 38-44
Djientcheu VDP, Nguefack S, Mouafo TO, Mbarnjuk AS, Yamgoue Y et al Hydrocephalus in toddlers: the place of shunts in sub-Saharan African countries. Child’s Nervous system. 2001
Adeloye A. Management of infantile hydrocephalus in central Africa. Trop Doct. 2001 ;31 :67–70.
Marano PJ, Stone SSD, Mugamba J, Ssenyonga P, Warf EB, Warf BC. Reopening of an obstructed third ventriculostomy: long-term success and factors affecting outcome in 215 infants. J Neurosurg Pediatr 2015 ; 15 :399–405.