Role of shunts with antisiphon device in treatment of pediatric hydrocephalus.
OBJECTIVE
The use of ventriculo-peritoneal shunts having antisiphon device has been reported in adult patients, but there is a dearth of experience with such shunts in pediatric age group. This study is being undertaken to compare the effectiveness of these types of shunt for the treatment of congenital hydrocephalus.


METHODS
Forty patients with congenital hydrocephalus with or without neural tube were divided randomly into two groups (A and B). Patients in antisiphon group were treated with shunts with differential valve including antisiphon device (Vygon shunt) while patients in non-antisiphon group were treated with differential valve shunts (Chhabra shunt and Ceredrain). Mann-Whitney test, asymmetric t-test and Chi-square test were used to assess the correlation and the significance.


RESULTS
The mean age was 3.5 months and 3.4 months in antisiphon group and non-antisiphon group, respectively. The M:F ratio was 2.3:1 in antisiphon group while it was 3:1 in non-antisiphon group. The mean decrease in OFC was more in non-antisiphon group than antisiphon group during the follow up from 3 months to 6 months while mean decrease in MEI was more in non-antisiphon group from 0 month to 3 months than antisiphon group. There were two cases of shunt overdrainage in non-antisiphon group. The shunt blockage rate was 20% in antisiphon group and 15% in non-antisiphon group, respectively. There was 20% and 15% shunt infection rate in antisiphon group and non-antisiphon group, respectively. This study demonstrated overdrainage syndrome in two of the patients of differential valve shunts.


CONCLUSIONS
Though rare, complication associated with overdrainage is certainly a problem in children. In our study, the patients who received shunts with antisiphon device do not show any overdrainage.
Khan
Rizwan A
RA
Department of Pediatric Surgery, PGIMER, Chandigarh, India. drrizwanahmadkhan@yahoo.co.in
Narasimhan
K L
KL
Tewari
Manoj K
MK
Saxena
Akshay K
AK
D004867:Equipment Design; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy*; D057446:Hydrodynamics; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation* / Q000379:methods