Can Preoperative Clinicoradiological Profile And Intraoperative Findings Truly Reflect the Outcome Of ETV Done In Infants For The Treatment Of Congenital Hydrocephalus – An Insight Via A Prospective Study

Author:

Verma Rajat1

Affiliation:

1. King George's Medical University

Abstract

Abstract Background Congenital hydrocephalus in infants treated with ETV have variable results in literature. We studied some supposed clinicoradiological parameters which though are considered vital in deciding operative management, have never been thoroughly studied to establish a well-defined association. Aim and objective To evaluate the influence of clinicoradiological profile and intraoperative findings over the outcome of ETV done in infants for congenital hydrocephalus. Materials and methods- All infants who underwent ETV in King George’s Medical University, Lucknow from January 2019 to February 2020 for congenital hydrocephalus were included. Their clinical, radiological, operative data was gathered. Infants were followed at 1, 3 and 6 months after ETV. ETV success was defined as stabilization of abnormal head growth with resolution of symptoms of raised ICP and no requirement of shunt surgery 6 months post ETV. All the clinicoradiological and intraoperative factors were statistically correlated with the final outcome. Results 40 infants were operated for congenital hydrocephalus during the study period in our institution. Failure rate was higher in children younger than 3 months (p value of 0.04). Increase in head size was present in all 40 cases and bulging anterior fontanelle in 95% cases. Success rate of ETV at 1, 3 and 6 months was 62.5%, 40% and 35%. Most of failure occurred within 3 months after the procedure. Expiry rate at 1, 3 and 6 month was 15%, 17.5% and 17.5%. None of the intraoperative findings significantly correlated with the final outcome. Conclusion ETV can be a luring treatment of congenital hydrocephalus in infants but has limited success with a minimal risk of fatal complications like CSF leak and meningitis associated with it. Age is the only factor which truly reflects the outcome of the procedure.

Publisher

Research Square Platform LLC

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