The symposium is co-organised by The Ann Conroy Trust, in association with Aesculap Academia.
The Ann Conroy Trust is Registered Charity No: 1165808.
We provide Support, Education and Research for patients living with Chiari Malformation, Syringomyelia and associated conditions.
F14 Paediatric endoscopic third ventriculostomy: long-term outcomes in Chiari & syringomyelia.
Parikh D, Slator N, Mundil N, Rodrigues D, Walsh AR, Solanki GA.
Endoscopic Third Ventriculostomy (ETV) is an established therapy for obstructive hydrocephalus. We review long-term outcomes at our institution and highlight the use of ETV for the lesser known indication of Chiari malformation and syringomyelia
A retrospective review of 139 ETVs performed between 2006 and 2017. The median follow-up was 69 months (range 3-132). Medical records were retrieved from our electronic database and imaging reviewed in our PACS system. Statistical methods performed included a time-to-event analysis (where event = further hydrocephalus procedure) and chi-squared test between observed and predicted success as per ETV Success Score (ETVSS)
130 Patients underwent 139 ETVs. The majority were older than 1 year. The commonest indication was aqueduct stenosis by tumour. In primary procedures the overall ETV success was 74%. The timing of ETV failure showed that 44% occurred in under 30 days and 25% between 30 days and 6 months. ETV success at 6 months was 82%. The predicted ETVSS was 71%, p=0.59 on a chi-square test. The percentage survival was evaluated with a Kaplan-Meier curve. ETV success in Chiari & syringomyelia was 9 out of every 10 cases.
The main discriminators of ETV success are neonatal age and aetiology. ETV alone has been successful in resolving Chiari I and syringomyelia associated with ventriculomegaly.