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Non-Tumor Obstructive Hydrocephalus Treated with Endoscopic Third Ventriculostomy in Cameroon

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DOI: 10.4236/ojmn.2015.54022    2,897 Downloads   3,406 Views   Citations

ABSTRACT

Objective: In Sub-Saharan Africa, shunt dependence is a real threat for patients. For this reason, any method allowing shunt independence such as endoscopic third ventriculostomy should be promoted. The goal of this study was to show the advantages of neuroendoscopy in treating non-tumor obstructive hydrocephalus in Cameroon. Methods: We retrospectively reviewed the cases of non-tumor obstructive hydrocephalus treated with endoscopic third ventriculostomy in our hospital. Results: Twenty patients (15 males, 5 females) underwent endoscopic third ventriculostomy as first choice treatment for non-tumor obstructive hydrocephalus. Their ages ranged from six months to 41 years (mean 11.96 years, median 20.75 years). Fourteen patients (70%) were children (≤18 years old), 6 were adults, 7 were under age of two years and 3 were below one. Computed tomography scan was the radiological tool used in all cases. None did a magnetic resonance imaging scan. Etiology of hydrocephalus was aqueductal stenosis in 18 cases and stenosis of the foramina of Luschka & Magendie in two. Aqueductal stenosis was associated with myelomeningocele in one case and shunt failure in another one. Endoscopic third ventriculostomy was successful in alleviating clinical symptoms with shunt independence in 19 cases (95%), but failed in one case. ETV success was not related to patient age. Cerebrospinal fluid leak occurred in two patients as post-operative complication (10%). Overall, ETV diminished treatment cost by 600 USD. Conclusion: Even in areas with limited medical equipment like in Sub-Saharan Africa where shunt dependence is a real danger, ETV can be routinely used to successfully treat non-tumor obstructive hydrocephalus.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Ndoumbe, A. , Simeu, C. and Motah, M. (2015) Non-Tumor Obstructive Hydrocephalus Treated with Endoscopic Third Ventriculostomy in Cameroon. Open Journal of Modern Neurosurgery, 5, 137-143. doi: 10.4236/ojmn.2015.54022.

References

[1] Idowu, O.E., Falope, L.O. and Idowu, A.T. (2009) Outcome of Endoscopic Third Ventriculostomy and Chhabra Shunt System in Noncommunicating Non-Tumor Childhood Hydrocephalus. Journal of Pediatric Neurosciences, 4, 66-69.
http://dx.doi.org/10.4103/1817-1745.57323
[2] Kamalo, P. (2013) Point of View: Exit Ventriculoperitoneal Shunt; Enter Endoscopic Third Ventriculostomy (ETV): Contemporary Views on Hydrocephalus and Their Implications on Management. Malawi Medical Journal, 25, 78-82.
[3] Ojo, O.A., Bankole, O.B., Kanu, O.O. and Okubadejo, N.U. (2015) Efficacy of Endoscopic Third Ventriculostomy in the Management of Hydrocephalus in Children under 2 Years of Age: Experience from a Tertiary Institution in Nigeria. Nigerian Journal of Clinical Practice, 18, 318-322.
http://dx.doi.org/10.4103/1119-3077.153245
[4] Piquer, J., Qureshi, M.M., Young, P.H. and Dempsey, R.J. (2015) Neurosurgery Education and Development Program to Treat Hydrocephalus and to Develop Neurosurgery in Africa Using Mobile Neuroendoscopic Training. Journal of Neurosurgery: Pediatrics, 15, 552-559.
http://dx.doi.org/10.3171/2014.10.peds14318
[5] Warf, B.C. and Campbell, J.W. (2008) Combined Endoscopic Third Ventriculostomy and Choroid Plexus Cauterization as Primary Treatment of Hydrocephalus for Infants with Myelomeningocele: Long-Term Results of a Prospective Intent-to-Treat Study in 115 East African Infants. Journal of Neurosurgery: Pediatrics, 2, 310-316.
http://dx.doi.org/10.3171/PED.2008.2.11.310
[6] Warf, B.C. (2005) Comparison of Endoscopic Third Ventriculostomy Alone with Choroid Plexus Cauterization in Infants Younger than 1 Year of Age: A Prospective Study in 550 African Children. Journal of Neurosurgery: Pediatrics, 103, 475-481.
http://dx.doi.org/10.3171/ped.2005.103.6.0475
[7] Warf, B.C. (2005) Comparison of 1-Year Outcomes for the Chhabra and Codman-Hakim Micro Precision Shunt Systems in Uganda: A Prospective Study in 195 Children. Journal of Neurosurgery, 102, 358-362.
[8] Warf, B.C. (2005) Hydrocephalus in Uganda: The Predominance of Infectious Origin and Primary Management with Endoscopic Third Ventriculostomy. Journal of Neurosurgery: Pediatrics, 102, 1-15.
http://dx.doi.org/10.3171/ped.2005.102.1.0001
[9] Venkataramana, N.K., Rao, S.A.V. and Naik, A.L. (2009) Endoscopic Third Ventriculostomy. Journal of Pediatric Neurosciences, 4, 108-112.
http://dx.doi.org/10.4103/1817-1745.57329
[10] Warf, B., Ondoma, S., Kulkarni, A., Donnelly, R., Ampeire, M., Akona, J., et al. (2009) Neurocognitive Outcome and Ventricular Volume in Children with Myelomeningocele Treated for Hydrocephalus in Uganda. Journal of Neurosurgery: Pediatrics, 4, 564-570.
http://dx.doi.org/10.3171/2009.7.PEDS09136
[11] Figaji, A.A., Fieggen, A.G. and Peter, J.C. (2003) Endoscopic Third Ventriculostomy in Tuberculous Meningitis. Child’s Nervous System, 19, 217-225.
[12] Zohdi, A.Z.M., El Damaty, A.M., Aly, K.B. and El Refaee, E.A. (2013) Success Rate of Endoscopic Third Ventriculostomy in Infants Below Six Months of Age with Congenital Obstructive Hydrocephalus (a Preliminary Study of Eight Cases). Asian Journal of Neurosurgery, 8, 147-152.
http://dx.doi.org/10.4103/1793-5482.121686
[13] Burtscher, J., Bartha, L., Twerdy, K., Eisner, W. and Benke, T. (2003) Effect of Endoscopic Third Ventriculostomy on Neuropsychological Outcome in Late Onset Idiopathic Aqueduct Stenosis: A Prospective Study. Journal of Neurology, Neurosurgery, and Psychiatry, 74, 222-225.
http://dx.doi.org/10.1136/jnnp.74.2.222
[14] Choi, J.-U., Kim, D.-S. and Kim, S.-H. (1999) Endoscopic Surgery for Obstructive Hydrocephalus. Yonsei Medical Journal, 40, 600-607.
http://dx.doi.org/10.3349/ymj.1999.40.6.600
[15] Furlanetti, L.L., Santos, M.V. and Santos de Oliveira, R. (2013) Neuroendoscopic Surgery in Children: An Analysis of 200 Consecutive Procedures. Arquivos de Neuro-Psiquiatria, 71, 165-170.
http://dx.doi.org/10.1590/S0004-282X2013000300007
[16] He, Z., An, C., Zhang, X., He, X. and Li, Q. (2015) The Efficacy Analysis of Endoscopic Third Ventriculostomy in Infantile Hydrocephalus. Journal of Korean Neurosurgical Society, 57, 119-122.
http://dx.doi.org/10.3340/jkns.2015.57.2.119
[17] Locatelli, M., Draghi, R., Di Cristofori, A., Carrabba, G., Zavanone, M., Pluderi, M., et al. (2014) Third Ventriculostomy in Late-Onset Idiopathic Aqueductal Stenosis Treatment: A Focus on Clinical Presentation and Radiological Diagnosis. Neurologia Medico-Chirurgica, 54, 1014-1021.
http://dx.doi.org/10.2176/nmc.oa.2013-0367
[18] Rezaee, O., Sharifi, G., Samadian, M., Haddadian, K., Ali-Asgari, A. and Yazdani, M. (2007) Endoscopic Third Ventriculostomy for Treatment of Obstructive Hydrocephalus. Archives of Iranian Medicine, 10, 498-503.
[19] Rhode, V., Behm, T., Ludwig, H. and Wachter, D. (2012) The Role of Neuronavigation in Intracranial Endoscopic Procedures. Neurosurgical Review, 35, 351-358.
http://dx.doi.org/10.1007/s10143-011-0369-7
[20] Yadav, Y.R., Mukerji, G., Parihar, V., Sinha, M. and Pandey, S. (2009) Complex Hydrocephalus (Combination of Communicating and Obstructive Type): An Important Cause of Failed Endoscopic Third Ventriculostomy. BMC Research Notes, 2, 137.
http://dx.doi.org/10.1186/1756-0500-2-137
[21] Brichtova, E., Chlachula, M., Hrbac, T. and Lipina, R. (2013) Endoscopic Third Ventriculostomy in Previously Shunted Children. Minimally Invasive Surgery, 2013, 1-4.
http://dx.doi.org/10.1155/2013/584567
[22] Chhun, V., Sacko, O., Boetto, S. and Roux, F.E. (2015) Third Ventriculocisternostomy for Shunt Failure. World Neurosurgery, 15, 211-219.
http://dx.doi.org/10.1016/j.wneu.2015.01.058
[23] Lee, S.H., Kong, D.S., Seol, H.J. and Shin, H.J. (2011) Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction. Journal of Korean Neurosurgical Society, 49, 217-221.
http://dx.doi.org/10.3340/jkns.2011.49.4.217
[24] Sokal, P., Birski, M., Rusinek, M., Paczkowski, D., Zielinski, P. and Harat, A. (2012) Endoscopic Third Ventriculostomy in the Treatment of Hydrocephalus. Videosurgery and Other Miniinvasive Techniques, 7, 280-285.
http://dx.doi.org/10.5114/wiitm.2011.30810
[25] Stachura, K., Grzywna, E., Kwinta, B.M. and Moskata, M.M. (2014) Endoscopic Third Ventriculostomy—Effective- ness of the Procedure for Obstructive Hydrocephalus with Different Etiology in Adults. Videosurgery and Other Miniinvasive Techniques, 9, 586-595.
http://dx.doi.org/10.5114/wiitm.2014.46076
[26] Yildrim, A.E., Karaoglu, D., Divanlioglu, D. and Belen, A.D. (2014) A Difficult Endoscopic Third Ventriculostomy Procedure: Perforation of a Thick Liliequist Membrane with High Basilar Artery Location. Turkish Neurosurgery, 24, 946-947.
http://dx.doi.org/10.5137/1019-5149.jtn.12847-14.1
[27] Ganjoo, P., Sethi, S., Tandon, M.S., Singh, D. and Pandey, B.C. (2010) Perioperative Complications of Intraventricular Neuroendoscopy. A 7-Year Experience. Turkish Neurosurgery, 20, 33-38.
[28] Larysz, P., Larysz, D. and Mandera, M. (2014) Radiological Findings in Relation to the Neurodevelopmental Outcome in Hydrocephalic Children Treated with Shunt Insertion or Endoscopic Third Ventriculostomy. Child’s Nervous System, 30, 99-104.
http://dx.doi.org/10.1007/s00381-013-2200-y
[29] Wisniewska, B., Mikolajczyk-Wieczorek, W., Polis, B., Polis, L., Zakrzewski, K. and Nowoslawska, E. (2012) The Long-Term Psychological Effects of Surgical Treatment Using Neuroendoscopic Techniques and Orbis Sigma Shunt Implantation in Children Suffering from Hydrocephalus. Advances in Clinical and Experimental Medicine, 21, 373-384.
[30] Oton de Lima, B. and Pratesi, R. (2014) Endoscopic Third Ventriculostomy Has No Higher Costs than Ventriculoperitoneal Shunt. Arquivos de Neuro-Psiquiatria, 72, 524-527. http://dx.doi.org/10.1590/0004-282X20140070

  
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