Endoscopic Third Ventriculostomy: a Surgeon’s Experience

Abstract

Introduction: Endoscopic third ventriculostomy (ETV) is considered an alternative treatment for certain types of hydrocephalus. Depending on patient’s age and etiology of hydrocephalus, it carries a success rate of around 90%. However, as in any surgical procedure, inherent risks are present and a risk-benefit analysis must be done prior to selecting patients for this intervention. Objective: To evaluate retrospectively the experience of ETV at the University of Puerto Rico and examine the etiological factors, demographic data and symptoms among the Puerto Rico population. This study represents the data of one neurosurgeon and is the first account of endoscopic third ventriculostomy as a mode of treatment in the Caribbean area. Methods: Retrospective analysis was undertaken of 29 patients treated at the University Pediatric Hospital (UPH) and University District Hospital (UDH) in San Juan was undertaken Different etiologies of hydrocephalus were identified and managed. Results: The most common indication for ETV was aqueductal stenosis (59%) with male predominance (55%). Also, the most common population treated were adults (72%) and the most common symptom presented were headaches (52%) and gait disturbances (43%). Conclusions: Endoscopic third ventriculostomy is a safe and effective way to treat hydrocephalus and should be considered as first choice of treatment for certain patients with hydrocephalus unless otherwise contraindicated.