Endoscopic Third Ventriculostomy Success Score (ETVSS) predicting success in a series of 50 pediatric patients. Are the outcomes of our patients predictable?
OBJECTIVE
In our series of endoscopic third ventriculostomy (ETV), we sought to establish the relationship between the preoperative prediction using the Endoscopic Third Ventriculostomy Success Score (ETVSS) and the postsurgical success rate.


METHODS
This descriptive analytical study comprised 50 pediatric patients who underwent 58 ETV procedures between 2003 and 2011. Data regarding clinical, surgical, and radiological findings were obtained from a continuously updated database. For each patient, we calculated the ETVSS, based on the patient's age, hydrocephalus etiology, and presence of a previous shunt. We considered success to be an established or improved clinical state and at least one of the following radiological criteria: (a) reduction in ventricular size or stable ventricles with disappearance of periventricular edema and increased subarachnoid space over cerebral convexities, (b) flow artifact in sagittal T2FSE MR, or (c) bidirectional flow signal in 2D-CPC MR. Statistical significance was set at p < 0.05. Six months was the minimum postoperative follow-up required.


RESULTS
The ETV was successful in 29 patients (58 %). Patients aged over 1 year achieved the best results (p < 0.019). For those who underwent successful ETV, the mean ETVSS was 71.03 (95 % CI, 66.23-75.84). In those for whom the ETV was not successful, the mean ETVSS was 60 (95 % CI, 53.09-66.90); (p < 0.007).


CONCLUSIONS
The success of ETV in our series could have been predicted by ETVSS. Predictability could help establish stricter surgical selection criteria, thereby obtaining higher success rates, as well as preparing the patients and their families for expected outcomes.
Department of Neurosurgery, HRU Carlos Haya, Avenida Carlos Haya s/n, 29010 Málaga, Spain. gonzalezgarcialaura@hotmail.com
Laura González
LG
García
Bienvenido Ros
BR
López
Guillermo Ibáñez
GI
Botella
Miguel Domínguez
MD
Páez
Sandra Pérez
SP
da Rosa
Francisca
F
Rius
Miguel Angel Arráez
MA
Sánchez
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D044583:Neuroendoscopy; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy