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 fossa
depending on extent of involvement and severity. DWS has been reported to occur in 1 of 25,000
to 30,000 newborns, with the majority of patients presenting in the first year most of them
present with hydrocephalus (70–90%). There are different treatment modalities to treat
hydrocephalus in Dandy-walker Malformation patients endoscopic Third ventriculostomy being
one of them. In our country Ethiopia, ETV has also been applicable for the treatment of the
hydrocephalus in those patients with DWM lately. Despite its applicability in the management of
Hydrocephalus 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 who
are treated with ETV at Zewditu Memorial Hospital.
Methods: Retrospectively collected data in 33 children with confirmed Dandy-Walker
Malformation patients who have undergone ETV was conducted at Zewditu Memorial Hospital
from January 2021 to May 2023. The Data collected was analyzed using SPSS. Frequency
distribution will be used to describe the characteristics of the patients. Data analysis was
performed 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 1
year. There was slight Male predominance than females 1.75:1. ETV was successfully done in
22(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 probability
was 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