title: Timing of endoscopic third ventriculostomy in pediatric patients with congenital obstructive hydrocephalus: assessment of neurodevelopmental outcome and short-term operative success rate.
abstract: The purpose of this study was to determine the impact of early (⩽6 months old), midterm (6-12 months old) and late (>12 months old) endoscopic third ventriculostomy (ETV) on the operative success rate and postoperative neurodevelopmental outcome of children with congenital obstructive hydrocephalus. We divided 63 children into three groups according to whether they underwent early, midterm or late ETV. Their preoperative developmental quotient (DQ) was assessed using the Gesell developmental diagnosis schedule (GDDS). Three and 6months after the initial procedure, GDDS was used to obtain postoperative DQ from two assessments (blinded and non-blinded). Meanwhile, two observers studied the operative success rate of initial ETV. There were no substantial differences between blinded and non-blinded assessments. The success rate of early ETV was only 20.8%. By contrast, this rate was 55% and 73.7% for midterm and late ETV, respectively. Before operation, we observed severe developmental abnormalities in all children (DQ score<40). However, children in midterm and late ETV groups achieved improvement after the operation, which was particularly remarkable in late ETV group. Six months after the first surgery, 16 (84.2%) children in the late ETV group, nine (45%) in the midterm ETV group and four (16.7%) in the early ETV group had moderate developmental disability. Nevertheless, overall prognosis for the three groups was not optimistic. There were no children with mild neurodevelopmental disability or normal function. Our data confirmed that age is a determinant for ETV effectiveness and overall prognosis.
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China.
authors.forename: Suerdanniya
authors.initials: S
authors.lastname: Tewuerbati
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China.
authors.forename: Mijiti
authors.initials: M
authors.lastname: Maimaitili
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Zhu
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China.
authors.forename: Guojia
authors.initials: G
authors.lastname: Du
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China.
authors.forename: Duisanbai
authors.initials: D
authors.lastname: Sailike
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China.
authors.forename: Yandong
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Neurosurgery, First Affiliated Teaching Hospital of Xinjiang Medical University, 137 Li Yu Shan Nan Road, Urumqi City, Xinjiang Autonomous Region, China. Electronic address: damrjab@163.com.
authors.forename: Geng
authors.initials: G
authors.lastname: Dangmurenjiafu
mesh_terms: D002648:Child; D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology / Q000523:psychology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D009483:Neuropsychological Tests; D015588:Observer Variation; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D020542:Third Ventricle / Q000473:pathology; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*
keywords: Congenital obstructive hydrocephalus; Endoscopic third ventriculostomy; Neurodevelopmental outcome; Pediatric neurosurgery