Role of choroid plexus cauterization in augmenting the success rate of endoscopic third ventriculostomy in Chiari II-associated hydrocephalus.

Authors

Mohamed Mohsen Amen, Mohamed Badran, Ahmed Zaher, Mostafa Shahein

Published in

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. Volume 42. Issue 1. Aug 04, 2026. Epub Aug 04, 2026.

Abstract

This study evaluates the efficacy and outcomes of endoscopic third ventriculostomy combined with choroid plexus cauterization (ETV + CPC) as a primary treatment for hydrocephalus associated with Chiari II malformation in infants.
This retrospective study analyzed 53 infants, all under 12 months of age and post-myelomeningocele repair, who presented with hydrocephalus (Evans' Index > 0.3 or Frontal occipital horn ratio (FOHR) > 0.4). All patients underwent Endoscopic third ventriculostomy (ETV) and bilateral choroid plexus cauterization (CPC) using a rigid endoscope. Success was defined as shunt-free survival with clinical and radiological improvement over a 12-month follow-up period.
The cohort of 53 infants (28 males, 25 females) had a mean age of 3.4 months, with 36% consanguinity. Patients were stratified into three age groups: < 3 months (n = 13), 3-6 months (n = 19), and 6-12 months (n = 21). The ETV + CPC success rate showed a positive correlation with age: 54% in the youngest group, 63% in the middle group, and 67% in the oldest group. Of the 20 failures, 14 required ventriculoperitoneal shunts (VPS), and 6 were managed with re-endoscopy for stoma closure. Meningitis was the most common complication (15%), with all affected patients eventually requiring a VP shunt.
ETV + CPC offers an effective, safe, and durable alternative to traditional VPS for infants with Chiari II-associated hydrocephalus. It significantly reduces shunt dependency and its associated long-term complications. Success rates improve with advancing age, making it a viable first-line surgical option in pediatric neurosurgery, particularly in resource-limited settings.

PMID:
42547648
Bibliographic data and abstract were imported from PubMed on 04 Aug 2026.

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