Treatment Outcome of Hydrocephalus among Patients with Dandy Walker Malformation Managed with ETV at Zewditu Memorial Hospital, from January 2021- May 2023 Addis Ababa, Ethiopia.
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Date
2023-11
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Addis Ababa University
Abstract
Background: Dandy-Walker complex (DWC) is a term coined to describe a continuum of posterior fossa anomalies categorizing spectrum of cystic malformation posterior fossadepending on extent of involvement and severity. DWS has been reported to occur in 1 of 25,000to 30,000 newborns, with the majority of patients presenting in the first year most of thempresent with hydrocephalus (70–90%). There are different treatment modalities to treat
hydrocephalus in Dandy-walker Malformation patients endoscopic Third ventriculostomy beingone of them. In our country Ethiopia, ETV has also been applicable for the treatment of thehydrocephalus in those patients with DWM lately. Despite its applicability in the management ofHydrocephalus its outcome hasn’t been properly assessed. This research aims at assessing the treatment outcomes of ETV.
Objectives: To assess the treatment outcomes of Hydrocephalus among patients with DWM whoare treated with ETV at Zewditu Memorial Hospital.
Methods: Retrospectively collected data in 33 children with confirmed Dandy-WalkerMalformation patients who have undergone ETV was conducted at Zewditu Memorial Hospitalfrom January 2021 to May 2023. The Data collected was analyzed using SPSS. Frequencydistribution will be used to describe the characteristics of the patients. Data analysis wasperformed using chi-squared tests and survival analysis by Kaplan-Meier tests to assess the treatment outcomes and survival probability.
Result: The median age at surgery was 7 months and 84.7% of the patients were less than 1year. There was slight Male predominance than females 1.75:1. ETV was successfully done in22(66.7%) of the patients with improvement in their initial presenting clinical sign & symptoms.The 6-month ETV failure rate was 33.3% to whom we did redo ETV/VP-shunting. All failures occurred within the first 6 months after surgery. The estimated cumulative survival probabilitywas 75.8% at 2.4 months, 70 % at 4 months and with mean follow up time of 18 months.
Conclusion: The 6 month ETV failure rate was 33.3%. Endoscopic third ventriculostomy should be strongly considered as primary management in treating DWC associated hydrocephalus.
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Keywords
Dandy walker Malformation Endoscopic third ventriculostomy Hydrocephalus