Endoscopic third ventriculostomy: An outcome analysis of 30 pediatric cases

OBJECTIVE: Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative in the surgical treatment of hydrocephalus. Our goal in this retrospective study is to analyze our results with the use of ETV in our first 30 cases that it may provide us with selection criteria as to who among our patients will benefit most from this procedure.METHODOLOGY: Thirty ETVs were performed in 30 patients. Their ages ranged from 2-155 months. Hydrocephalus was caused by aqueductal stenosis in 17 patients, tumors in 7, post-infectious in 3, Dandy-Walker malformation in 2 and arachnoid cyst in 1 patient. The outcome of ETV was evaluated in 26 of the cases that were available for follow-up RESULTS: The overall success rate was 69.2 percent. Patients with non-communicating hydrocephalus from post-infectious causes, tumors and aqueductal stenosis had high success rates. Patients less than 6 months of age had a poor outcome. Complications included ventriculitis in 1 patient CONCLUSION: ETV is a viable treatment option for non-communicating hydrocephalus secondary to post-infectious cause, aqueductal stenosis and tumors. A successful outcome is more likely if ETV is done in patients more than 6 months of age Patients who have previously undergone shunting and who have non-communicating hydrocephalus should undergo ETV at the time of shunt failure. These patients showed good outcome.

Radiofrequency rhizotomy in the treatment of trigeminal neuralgia: A 12-year experience

This was a prospective case series of 95 consecutive patients with trigeminal neuralgia treated by the author over the last 12 years (November 1986 to November 1998) using radiofrequency rhizotomy as the surgical procedure. The procedure was evaluated in terms of its efficacy in pain relief, safety with regards to mortality and morbidity, and ease of application by way of successful access of the Gasserian ganglion for lesion making. Results showed that 94.7 per cent rate of immediate pain relief with a 5.3 per cent rate of immediate pain recurrence. Ninety per cent experienced excellent long term pain relief with a 20 per cent delayed recurrence rate. There was no mortality encountered. The morbidity rate was low, and included ipsilateral corneal anesthesia (8), mild masseter weakness (7) and dysesthesia (6).