SEARCHCOHORTpediatric ophthalmology, neurology

cohort·pediatric ophthalmology, neurology, surgery, pediatrics, clinical trial·PMC10064391

Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization in Infantile Hydrocephalus: An Experience from Mali

Pediatric Neurosurgery · 6 authors, 3 centres

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TL;DR

This retrospective study evaluated endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) for infantile hydrocephalus in Mali, finding that the overall success rate at 12 months was 47% and that patient age significantly influenced the likelihood of a successful outcome without a shunt.

Full summary

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The study performed a retrospective analysis of 199 infants under 12 months with hydrocephalus who underwent ETV/CPC at a center in Mali between July 2013 and January 2015. The overall success rate was 47%, with success rates varying significantly by age group: 29% for infants ≤3 months, 54% for those 3–6 months, and 69% for those 6–12 months. Statistical analysis showed a significant difference in success rates between the youngest and oldest age groups (p = 0.007).

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cohort

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pediatric ophthalmology

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ORIGINAL PAPER

PMC10064391

Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization in Infantile Hydrocephalus: An Experience from Mali

Pediatric Neurosurgery

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ABSTRACT

Abstract Introduction Pediatric hydrocephalus is a common disease in sub-Saharan Africa. In Mali, 350–400 new cases are diagnosed in our center yearly. With a total land mass of 1,241,000 km<sup>2</sup>, patients in remote areas must travel up to 1,500 km to access neurosurgical care. Hence, treatment and follow-ups of “shunted” patients are difficult. In this context, endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) provides an opportunity for an affordable and less constraining treatment for hydrocephalus children under 12 months of age. Methods We performed a retrospective analysis of ETV/CPC performed on infants from July 2013 to January 2015. Patients were followed postoperatively on day 15, month 6, and month 12. Statistical analysis was conducted using Prism 9 GraphPad software. ETV successes were categorized according to the patient's age into 3 groups: ≤3 months, 3–6 months, and 6–12 months. Statistical significance was defined at p < 0.05. Results During the study period, 199 patients were included with 40% of patients aged between 0 and 6 months. The head circumference ranged from 35 cm to 79 cm. The etiology was congenital malformation in 55%. ETV/CPC was a success in 69% of 6- to 12-month-old patients, 54% in the 3- to 6-month-old patients, and 29% in ≤3-month-old patients. Overall, 94 (47%) patients were successfully treated without a shunt. The postoperative infection rate was 1% and mortality at 12 months was 8%. Conclusion In a low-income environment such as Mali, ETV/CPC stands as a viable and alternative treatment option for pediatric hydrocephalus patients; our findings suggest that age is an important factor in predicting ETV success. Keywords: Endoscopic third ventriculostomy, Choroid plexus cauterization, Hydrocephalus, Pediatric hydrocephalus, Outcomes

CITATION EXPORT

Oumar Diallo, Mahamadou Dama, Landry Konan et al.. Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization in Infantile Hydrocephalus: An Experience from Mali. Pediatric Neurosurgery. (2023). https://doi.org/10.1159/000529453

AUTHORS

6 · 3 CENTRES

Oumar Diallo, Mahamadou Dama, Landry Konan, Oumar Coulibaly, Daouda Sissoko, Abdoulaye Hima Maiga

aDepartment of Neurosurgery, Hospital of Mali, University of Sciences, Technics and Technology of Bamako (USTTB), Bamako, Mali
bDepartment of Neurosurgery CHU Yopougon, University Felix Houphouët Boigny, Abidjan, Ivory Coast
cDepartment of Neurosurgery, General Hospital of Niamey, University Abdou Moumouni, Niamey, Niger