gms | German Medical Science

Objective: Endoscopic Third Ventriculostomy (ETV) is well established in the treatment of hydrocephalus in pediatric patients. However, there is a lack of data with regard to the quality of life of these patients during long-term follow-up.

Methods: All ETV performed in patients younger than 18 years at the University Medicine Greifswald between 1993 and 2016 were included. All patients, who are older than 14 years today were assessed with the SF-12 questionnaire. The SF-12 gives information about the physical and mental well-being (average value is 50 points, standard deviation of 10 points). Patients younger than 14 years of age were assessed with the KINDL questionnaire completed by their parents (max. value of 100 points). The values were compared with the corresponding norm curves. Comparative analysis between patients with ETV success and failure (defined as shunt dependency) was done.

Results: 119 ETV were done in 107 patients (53 f and 54 m, 6.8 years mean age, range from 2 days to 17.7 years). Mean follow-up was 8.9 years. ETV was successful in 55% (59/107) and not successful in 42% (45/107) of the patients. 3% (3/107) were lost to follow up immediately after the operation.18/107 patients died due to natural course of their disease. From the remaining patients (89/107) 49 completed the questionnaire. Of these, 35/49 patients were assessed with the SF-12 and the calculated value for the physical and mental scale was 47.15 points and 51.54 points, respectively, what is within the range of the normal population. 14/49 patients were assessed with the KINDL questionnaire. The total score of patients younger than 6 years (n=6) was 72.92 points vs. 80.04 points of the normal population. The total score of the group above 6 years (n=8) was 68.88 vs. 76.75 points of the normal population. For both groups (assessed with SF-12 or KINDL) no statistically significant differences could be obtained between ETV success and ETV failure.

Conclusion: Our analysis shows that patients who underwent ETV in childhood do not have a lower health-related quality of life than the age matched group of a normal population and no differences could be obtained between patients with ETV success and ETV failure. Nevertheless, the current study has its limitations. At first, quality of life was not assessed before surgery. Second, the analysis is based on a pooled disease spectrum because subgroup analysis is not possible due to the low number of patients.