Outcome Of ETV Under Six Months: Endoscopic Anatomical Characteristics Among Hydrocephalic Patients Under 6 months Age Who Underwent ETV At Moi

Abstract

Objectives: This study aimed to analyse the association between the sociodemographic characteristics, clinical characteristics and the endoscopic anatomical findings. We also assessed the one year ETV success rates in our cohort. Methods: A retrospective analysis of a prospectively maintained hydrocephalus database of patients under 6months who underwent ETV was done. Data was collected on demographic and clinical characteristics, anatomical findings and twelve months follow up. The bivariable relationships were tested using Chi-square, and Mann-Whitney U tests. Statistical significance was set at 0.05, and all analysis was done on R studio. Results: We admitted 277 patients with a mean age of 2.67±1.7 months during the study period. Most patients were male (60.3%) and two months or less (51.9%). The older patients were more likely to have an abnormal OFC, with a mean OFC of 51.4±6.3 cm (p<0.001). Most of the mothers were above 20 years, and only a few had an ultrasound done with the majority having CT scan done at some point during their pregnancy. Younger infants had a more normal cortical mantle (51 vs 29, 1.96(1.12, 3.49) p = 0.018). Endoscopic evidence of infection and a scarred cistern was associated with a clinical diagnosis of infection p < 0.05. Patients who lived in a rural setting were more likely to have positive evidence of infection on endoscopy [1.7 (1.05, 2.96) p = 0.025]. Furthermore, patients who had an abnormal OFC had a thin cortical mantle and a not intact septum (P <0.001). The ETV success rates at 4, 26, and 52 weeks were 93.1%, 76.1%, and 63.4%, respectively. Conclusions: Age, clinical signs of infection and OFC are all clinical and sociodemographic factors associated with distinct endoscopic findings during an ETV. Our cohort had success rates comparable to those reported in the literature.