Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect
International Journal of Neurosurgery
Volume 3, Issue 2, December 2019, Pages: 32-37
Received: Nov. 20, 2019; Accepted: Dec. 3, 2019; Published: Dec. 10, 2019
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Ahmed Zahe, Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Mahmoud Saad, Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Abdelghany Elshamy, Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Background: Different surgical management of infants suffering neural tube defects (NTD) associated hydrocephalus were reported in the literature. Great debate whether combining endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is more effective than ventriculoperitoneal (VP) shuntfor management of congenital hydrocephalus secondary to neural tube defects ininfants younger than 1 year of age. Purpose: To evaluate and compare the therapeutic efficacy of ETV combined with CPC versus VP shunts in infants with infantile hydrocephalus associated with NTD. Methods: Thirty infants with infantile NTD associated hydrocephalus (de novo), were equally divided and randomly allocated to each intervention group either ETV/CPC or VP shunts). They were monitored for at least 6 months for any sign of raised intracranial pressure (rICP) and/or hydrocephalic metrics (fontanelle quality, HC, and ventricular size) were also documented and compared between two groups. Statistical Analysis: The association between intervention group and outcome was tested with Chi-square test and P=0.05 or less was considered statistically significant. Results: Of the total thirty patients included in the study, thirteen patients (43.3%) were male and seventeen were female (56.7%) with mean age of 80.3±11.5 days. Twenty patients (66%) were under 6 months of age. The overall success rate in 1-year follow-up was 54% and 60% for VP shunt and ETV/CPC, respectively; with the difference being not statistically significant. Conclusion: Combined ETV-CPC is considered a successful surgical option for treatment of infantile hydrocephalus associated with NTD; achieving success rate better than VPS implantation.
Endoscopic Third Ventriculostomy, Choroid Plexus Cauterization, Neural Tube Defect, Hydrocephalus
To cite this article
Ahmed Zahe, Mahmoud Saad, Abdelghany Elshamy, Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect, International Journal of Neurosurgery. Vol. 3, No. 2, 2019, pp. 32-37. doi: 10.11648/j.ijn.20190302.14
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This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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