Artikel
Endocrine changes following endoscopic third ventriculostomy (ETV) in children
Endokrinologische Veränderungen nach endoskopischer Third Ventrikulostomie bei Kindern
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Autoren
Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
ETV is a standard procedure for the treatment of obstructive hydrocephalus in children. The main part of the procedure is the perforation of the third ventricle floor (Tuber cinereum). This structure is part of the hypothalamus - pituitary neuronal network of cerebral endocrine regulation. So far there are no data available about endocrine dysfunction following ETV in children.
Methods
We examined the last 20 consecutive children who had undergone ETV. Examination included laboratory tests (e.g. TSH, T3, T4, cortisol, ACTH, prolactin, electrolytes); measurement of weight, height, head circumference; Denver development scale; physical examination; in selected patients x-ray of the left hand. The study had received the ethic commission vote. Consent was obtained from the parents.
Results
Eight patients had at least one abnormal value in the laboratory endocrine evaluation. Nine patients demonstrated irregularities in their weight or height development when plotted to the age determined percentile curves. No single parameter was distorted in all or most of the patients.
Conclusions
We conclude that more patients than expected demonstrated endocrine abnormalities. We have to consider that some of the patients may have endocrine abnormalities secondary to their primary disease (tumor, trauma, meningitis). However, ETV may lead to significant endocrine dysfunction in pediatric patients. This has to be part of the preoperative consent. Further studies are necessary in the future, especially pre- and postoperative endocrine evaluation in order to compare the results.