title: Endoscopic third ventriculostomy with/without choroid plexus cauterization for hydrocephalus due to hemorrhage, infection, Dandy-Walker malformation, and neural tube defect: a meta-analysis.
abstract: OBJECTIVE
  Endoscopic third ventriculostomy (ETV) is a viable alternative to CSF shunting in hydrocephalic patients and is used with varying degrees of success dependent on age and etiology. The purpose of this meta-analysis is to analyze data on ETV and ETV/CPC (choroid plexus cauterization) outcomes in hopes of providing a clear understanding of their limitations in patients with hydrocephalus due to hemorrhage, infection, Dandy-Walker malformation, or neural tube disorders.
  
  
  METHODS
  An extensive PubMed search dating back 11 years was performed on primary ETV or ETV/CPC procedures for hydrocephalus due to infection, hemorrhage, neural tube defects, and Dandy-Walker malformation. ETV success was defined as no intraoperative or post-operative complications and no need for revision surgery at follow-up.
  
  
  RESULTS
  Ten studies were identified for analysis. The data represent 534 patients undergoing primary ETV and 167 patients undergoing primary ETV/CPC. The ETV group reached a 55 % success rate, while the ETV/CPC group reached a 67 % success rate. Success rates of ETV alone for hydrocephalus due to infection, neural tube defects, and intraventricular hemorrhage reached 54, 55, and 57 %, respectively. 84 % success was found in patients older than 2 years of age and 52 % success in patients less than 2 years of age.
  
  
  CONCLUSIONS
  ETV is a valid treatment for hydrocephalus of any etiology. There exists a small difference in success rates between infection, hemorrhage, and neural tube disorders, though not enough to discount ETV for these etiologies. Initial data utilizing ETV/CPC are promising, and additional studies will need to be done to verify such results.
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, West Indies, Grenada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Zandian
authors.forename: Matthew
authors.initials: M
authors.lastname: Haffner
authors.forename: James
authors.initials: J
authors.lastname: Johnson
authors.forename: Curtis J
authors.initials: CJ
authors.lastname: Rozzelle
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
mesh_terms: D002425:Cautery / Q000379:methods*; D002494:Central Nervous System Infections / Q000150:complications; D002543:Cerebral Hemorrhage / Q000150:complications; D002831:Choroid Plexus / Q000601:surgery; D003616:Dandy-Walker Syndrome / Q000150:complications; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D009436:Neural Tube Defects / Q000150:complications; D044583:Neuroendoscopy / Q000379:methods*; D020542:Third Ventricle / Q000601:surgery*; D014696:Ventriculostomy / Q000379:methods*