Supplementary Material for: Endoscopic Third Ventriculostomy in Infants Less than One Year of Age: A Short Series of 14 Cases

<b><i>Background:</i></b> Endoscopic third ventriculostomy (ETV) is currently considered as an alternative to cerebrospinal fluid (CSF) shunt systems in the treatment of obstructive hydrocephalus. This procedure allows the CSF to drain in the basal cisterns and reabsorbed by arachnoid granulations, and avoiding implantation of exogenous material. <b><i>Aims and Objectives:</i></b> The purpose of this study was to assess the success rate of ETV in infants less than 1 year of age with congenital noncommunicating hydrocephalus. <b><i>Material and Methods:</i></b> This study was a 2-year prospective study from August 2017 to July 2019. ETVs were performed in 14 patients younger than 1 year with diagnosis of noncommunicating hydrocephalous. A failure was defined as the need for shunt implantation after ETV. Phase-contrast MRI of the brain was done after 6 months to see patency of ETV fenestration and CSF flow through ventriculostomy. <b><i>Results:</i></b> ETV was tried in 18 patients and successfully performed in 14 patients. Out of the 14 patients, shunt implantation after ETV was performed in 3 patients (failed ETV). In the successful cases, etiology was idiopathic aqueductal stenosis in 8, shunt complications in 2, and 1 case was a follow-up case of occipital encephalocele; the mean age was 7.7 months (range 3–12). In the 3 failed cases, etiology was aqueductal stenosis, mean age was 7.6 months (range 3–11). In all ETVs, failed patients MPVP shunting was done. Follow-up of nonshunted patients was done from 6 to 24 months (mean 15 months). There was no mortality or permanent morbidity noted following ETV. <b><i>Conclusion:</i></b> ETV is a good surgical procedure for less than 1-year-old children.

<b><i>背景：</i></b> 目前，内镜第三脑室造瘘术（Endoscopic third ventriculostomy, ETV）被视为梗阻性脑积水治疗中脑脊液（cerebrospinal fluid, CSF）分流系统的替代术式。该操作可使脑脊液流入基底池并经蛛网膜颗粒重吸收，同时避免外源性植入材料的使用。
<b><i>研究目的与目标：</i></b> 本研究旨在评估年龄不足1岁的先天性非交通性脑积水患儿接受内镜第三脑室造瘘术的手术成功率。
<b><i>材料与方法：</i></b> 本研究为2017年8月至2019年7月开展的为期2年的前瞻性研究。共纳入14例年龄不足1岁、确诊为非交通性脑积水的患儿实施内镜第三脑室造瘘术。以ETV术后需行脑脊液分流术作为手术失败的判定标准。术后6个月对患儿行颅脑相位对比MRI（phase-contrast MRI）检查，以观察内镜第三脑室造瘘口的通畅性及脑脊液经造瘘口的流动情况。
<b><i>结果：</i></b> 本研究共对18例患儿尝试实施内镜第三脑室造瘘术，其中14例手术成功。14例手术成功的患儿中，3例术后需行分流植入术（即ETV失败病例）。成功手术病例的病因构成如下：特发性导水管狭窄8例、分流术相关并发症2例，另有1例为枕部脑膨出的随访病例；患儿平均年龄为7.7个月（年龄范围3~12个月）。3例ETV失败病例的病因均为导水管狭窄，平均年龄7.6个月（年龄范围3~11个月）。所有ETV失败患儿均接受了MPVP分流术。未行分流术的患儿随访时间为6~24个月，平均随访时长15个月。内镜第三脑室造瘘术后未出现死亡或永久性致残病例。
<b><i>结论：</i></b> 内镜第三脑室造瘘术是一种适用于年龄不足1岁患儿的优良外科治疗方案。