Treatment Outcome Of Endoscopic Third Ventriculostomy In Obstructive Hydrocephalus Patients At Tikur Anbessa Specialized Hospital And Myung Sung Christian Medical Center From January 1 2016 To June 30 2020 G.c

Objective: To analyse the overall outcome of ETV in obstructive hydrocephalus in relation tornneurosurgery experiences on patient selection, intraoperative incidents, post-operativerncomplications and follow up results. Predictors for post op complications, factors responsible forrnsuccessful outcome and validation of ETVSS for adult patients were also taken into account. rnMethodology: Institution based cross sectional retrospective study was conducted among 68rnpatients for whom ETV has been done at Tikur Anbessa Specialised Hospital and MCM hospitalrnfrom January 1 2016 to June 30 2020 G.C. Data obtained for analysis included patientrndemographics, clinical manifestations, underlying etiology, ETVSS, peri operative incidents and rnfollow up results. Collected data from patients’ medical chart using data collection checklist wasrnchecked for completeness, coded and entered to SPSS version 25 for analysis. Descriptive statisticsrnand Binary Logistic Regression were used for data analysis. rnResults: Mean age at the time of procedure was 29.4yrs (Range from 2years to 68 years, SD=17.8).rnof which, patients aged ≥ 15 years constituted 76.5% of study population. Brain tumours (67.9%),rnAqueductal Stenosis (14.7%), and PIH (11.8%) were causes of hydrocephalus in most studyrnparticipants. Intraoperative uncontrolled haemorrhage (13.2%) and distorted 3rd ventricular floorrnanatomy (7.3%) has led to insertion of EVDs in 19.1% that subsequently led to ventriculitis inrn11.8% (61.5% of all EVDs). Other encountered post op complications are IVH (14.7%), ICHrn(4.4%) and CSF leak (4.4%) with overall morbidity of 22%. With a mean follow up of 7.45 months,rnthe total number of patients with shunt free survival up to their last follow up month becomes 59 rnwith overall successful outcome of 86.7%. The mean duration of ETV failures were found to be on rn20th post-operative day (range 5 to 52 days). Younger age (31.2%, PIH (50%), uncontrolledrnbleeding (44.4%), distorted ventricular anatomy (60%), EVD insertion (53.8%), ventriculitis (75%)rnand post op IVH (40%) were associated with failed outcome. Among the 68.7% of patients with arnhigh probability of ETVSS 93.6% had a successful outcome. rnConclusions: Endoscopic third ventriculostomy is a safer and more effective treatment option forrnobstructive hydrocephalus. Factors indicating potential poor ETV outcome are distorted ventricular rnanatomy, post op IVH and ventriculitis

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