Endoscopic third ventriculostomy (ETV) for Chiari 1 malformation: a systematic review and meta-analysis.
Chiari malformation type 1
Endoscopic third ventriculosmy
Hydrocephalus
Meta-analysis
Tonsillar herniation
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
07 Aug 2024
07 Aug 2024
Historique:
received:
12
06
2024
accepted:
26
07
2024
revised:
22
07
2024
medline:
8
8
2024
pubmed:
8
8
2024
entrez:
7
8
2024
Statut:
epublish
Résumé
Meta-analysis and systematic review. To understand the role of endoscopic third ventriculostomy (ETV) for the treatment of concurrent Chiari Malformation Type I (CMI) and hydrocephalus in adults. A literature search on PubMed and Medline with MeSH terms relating to ETV and CMI identified 155 articles between 1988 and 2024. After excluding pediatric cases and other CNS pathologies with associated CMI, 11 articles met inclusion criteria. The Newcastle-Ottawa Scale was identified to assess heterogeneity and risk of bias among the 11 studies analyzed in this systematic-review and meta-analyses compared pre- and post-operative outcomes to examine the use of ETV as a treatment modality for CMI with hydrocephalus. From the 11 included studies, 35 cases of concurrent CMI and hydrocephalus treated with ETV were identified. ETV provided a pooled rate of symptom resolution or improvement of 66%. Additionally, meta-analysis discovered the following pooled rates: a reduction of tonsillar descent in 94% of patients, decreased ventriculomegaly in 94%, and ETV patency in 99%. Syringomyelia, nausea, papilledema and cerebellar dysfunction did not have sufficient numbers for meaningful statistical analyses. However, in each of these categories, more than 85% of the symptoms or radiographic findings improved. This review summarizes the safety and efficacy of ETV for the concurrent management of acquired CMI with hydrocephalus. Specifically, ETV improves radiological outcomes of both ventriculomegaly and tonsillar descent as well as the most prevalent neurological symptom, headaches.
Identifiants
pubmed: 39112685
doi: 10.1007/s10143-024-02623-6
pii: 10.1007/s10143-024-02623-6
doi:
Types de publication
Journal Article
Systematic Review
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
408Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Chiari H (1987) Concerning alterations in the cerebellum resulting from cerebral hydrocephalus. 1891. Pediatr Neurosci 13(1):3–8
doi: 10.1159/000120293
pubmed: 3317333
Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C et al (1999) Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44(5):1005–1017
doi: 10.1097/00006123-199905000-00042
pubmed: 10232534
Sharma H, Treiber JM, Bauer DF (2021) Chiari 1 and hydrocephalus - A review. Neurol India 69(Supplement):S362–S366
pubmed: 35102989
Di Rocco C, Frassanito P, Massimi L, Peraio S (2011) Hydrocephalus and Chiari type I malformation. Childs Nerv Syst 27(10):1653–1664
doi: 10.1007/s00381-011-1545-3
pubmed: 21928030
Tubbs RS, McGirt MJ, Oakes WJ (2003) Surgical experience in 130 pediatric patients with Chiari I malformations. J Neurosurg 99(2):291–296
doi: 10.3171/jns.2003.99.2.0291
pubmed: 12924703
Koueik J, DeSanti RL, Iskandar BJ (2022) Posterior fossa decompression for children with Chiari I malformation and hydrocephalus. Childs Nerv Syst 38(1):153–161
doi: 10.1007/s00381-021-05377-4
pubmed: 34671850
Hayhurst C, Osman-Farah J, Das K, Mallucci C (2008) Initial management of hydrocephalus associated with Chiari malformation Type I-syringomyelia complex via endoscopic third ventriculostomy: an outcome analysis. J Neurosurg 108(6):1211–1214
doi: 10.3171/JNS/2008/108/6/1211
pubmed: 18518729
Massimi L, Pennisi G, Frassanito P, Tamburrini G, Di Rocco C, Caldarelli M (2019) Chiari type I and hydrocephalus. Childs Nerv Syst 35(10):1701–1709
doi: 10.1007/s00381-019-04245-6
pubmed: 31227858
Wu Y, Li C, Zong X, Wang X, Gui S, Gu C et al (2018) Application of endoscopic third ventriculostomy for treating hydrocephalus-correlated Chiari type I malformation in a single Chinese neurosurgery centre. Neurosurg Rev 41(1):249–254
doi: 10.1007/s10143-017-0844-x
pubmed: 28326451
Tubbs RS, Lyerly MJ, Loukas M, Shoja MM, Oakes WJ (2007) The pediatric Chiari I malformation: a review. Childs Nerv Syst 23(11):1239–1250
doi: 10.1007/s00381-007-0428-0
pubmed: 17639419
Osuagwu FC, Lazareff JA, Rahman S, Bash S (2006) Chiari I anatomy after ventriculoperitoneal shunting: posterior fossa volumetric evaluation with MRI. Childs Nerv Syst 22(11):1451–1456
doi: 10.1007/s00381-006-0118-3
pubmed: 16733759
Vankipuram S, Ellenbogen J, Sinha AK (2022) Management of Chiari 1 malformation and hydrocephalus in syndromic craniosynostosis: a review. J Pediatr Neurosci 17(Suppl 1):S67–S76
pubmed: 36388008
pmcid: 9648655
Peleggi AF, Lovely TJ (2012) Treatment of delayed Chiari malformation and syringomyelia after lumboperitoneal shunt placement: Case report and treatment recommendations. Surg Neurol Int 3:101
doi: 10.4103/2152-7806.100369
pubmed: 23061017
pmcid: 3463835
Tubbs RS, Beckman J, Naftel RP, Chern JJ, Wellons JC 3rd, Rozzelle CJ et al (2011) Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I. J Neurosurg Pediatr 7(3):248–256
doi: 10.3171/2010.12.PEDS10379
pubmed: 21361762
De Vlieger J, Dejaegher J, Van Calenbergh F (2019) Posterior fossa decompression for Chiari malformation type I: clinical and radiological presentation, outcome and complications in a retrospective series of 105 procedures. Acta Neurol Belg 119(2):245–252
doi: 10.1007/s13760-019-01086-7
pubmed: 30737652
Hoffman HJ, Tucker WS (1976) Cephalocranial disproportion. A complication of the treatment of hydrocephalus in children. Childs Brain 2(3):167–76
pubmed: 971636
Talamonti G, Picano M, Fragale M, Marcati E, Meccariello G, Boeris D et al (2023) Reoperation in Chiari-1 Malformations. J Clin Med 12(8)
Pritz MB (2003) Surgical treatment of Chiari I malformation: simplified technique and clinical results. Skull Base 13(3):173–177
doi: 10.1055/s-2003-43328
pubmed: 15912175
pmcid: 1131847
Parker SR, Harris P, Cummings TJ, George T, Fuchs H, Grant G (2011) Complications following decompression of Chiari malformation Type I in children: dural graft or sealant? J Neurosurg Pediatr 8(2):177–183
doi: 10.3171/2011.5.PEDS10362
pubmed: 21806360
Knafo S, Malcoci M, Morar S, Parker F, Aghakhani N (2022) Surgical management after Chiari decompression failure: craniovertebral junction revision versus shunting strategies. J Clin Med 11(12)
Jenkinson MD, Hayhurst C, Al-Jumaily M, Kandasamy J, Clark S, Mallucci CL (2009) The role of endoscopic third ventriculostomy in adult patients with hydrocephalus. J Neurosurg 110(5):861–866
doi: 10.3171/2008.10.JNS17667
pubmed: 19284240
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 372:n160
doi: 10.1136/bmj.n160
pubmed: 33781993
pmcid: 8005925
Decq P, Le Guerinel C, Sol JC, Brugieres P, Djindjian M, Nguyen JP (2001) Chiari I malformation: a rare cause of noncommunicating hydrocephalus treated by third ventriculostomy. J Neurosurg 95(5):783–790
doi: 10.3171/jns.2001.95.5.0783
pubmed: 11702868
Salem-Memou S, Amal T, Salihy SM, Soumare O, Najat B (2021) Endoscopic third ventriculostomy in the fourth ventricle outlet obstruction associated with chiari malformation Type I and syringomyelia: case report. Asian J Neurosurg 16(1):170–173
doi: 10.4103/ajns.AJNS_67_20
pubmed: 34211888
pmcid: 8202361
Konar SK, Shukla D, Devi BI (2018) Neuroendoscopic management of coexisting congenital agenesis of bilateral foramen of monro with aqueductal stenosis and Chiari malformation: case report and review of the literature. World Neurosurg 118:55–58
doi: 10.1016/j.wneu.2018.07.016
pubmed: 30017764
Métellus P, Dufour H, Levrier O, Grisoli F (2002) Endoscopic third ventriculostomy for treatment of noncommunicating syringomyelia associated with a Chiari I malformation and hydrocephalus: case report and pathophysiological considerations. Neurosurgery. 51(2):500–3 discussion 3-4
doi: 10.1227/00006123-200208000-00036
pubmed: 12182791
Kumar SS, Chumas P, Peckham D, Guthrie A, Murray RD (2010) Hypogonadotropic hypogonadism: a consequence of Chiari-I malformation. Pituitary 13(2):183–185
doi: 10.1007/s11102-008-0142-2
pubmed: 18800246
Mohanty A, Suman R, Shankar SR, Satish S, Praharaj SS (2005) Endoscopic third ventriculostomy in the management of Chiari I malformation and syringomyelia associated with hydrocephalus. Clin Neurol Neurosurg 108(1):87–92
doi: 10.1016/j.clineuro.2004.11.017
pubmed: 16311156
Teo C, Nakaji P, Serisier D, Coughlan M (2005) Resolution of trigeminal neuralgia following third ventriculostomy for hydrocephalus associated with Chiari I malformation: case report. Minim Invasive Neurosurg 48(5):302–305
doi: 10.1055/s-2005-915597
pubmed: 16320194
Massimi L, Pravatà E, Tamburrini G, Gaudino S, Pettorini B, Novegno F et al (2011) Endoscopic third ventriculostomy for the management of Chiari I and related hydrocephalus: outcome and pathogenetic implications. Neurosurgery 68(4):950–956
doi: 10.1227/NEU.0b013e318208f1f3
pubmed: 21221038
Rezaee O, Sharifi G, Samadian M, Haddadian K, Ali-Asgari A, Yazdani M (2007) Endoscopic third ventriculostomy for treatment of obstructive hydrocephalus. Arch Iran Med 10(4):498–503
pubmed: 17903055
Rousseau M, Evans J (2017) Key statistical assumptions and methods in one-arm meta-analyses with binary endpoints and low event rates, including a real-life example in the area of endoscopic colonic stenting. Cogent Med 4(1)
Higgins JPT TJ, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors) (2023) Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). . Cochrane, Available from www.training.cochrane.org/handbook.2023
Kandasamy J, Kneen R, Gladstone M, Newman W, Mohamed T, Mallucci C (2008) Chiari I malformation without hydrocephalus: acute intracranial hypertension managed with endoscopic third ventriculostomy (ETV). Childs Nerv Syst 24(12):1493–1497
doi: 10.1007/s00381-008-0672-y
pubmed: 18626650
Oertel J, Vulcu S, Eickele L, Wagner W, Cinalli G, Rediker J (2017) Long-Term follow-up of repeat endoscopic third ventriculostomy in obstructive hydrocephalus. World Neurosurg 99:556–565
doi: 10.1016/j.wneu.2016.12.072
pubmed: 28034816
Breimer GE, Dammers R, Woerdeman PA, Buis DR, Delye H, Brusse-Keizer M et al (2017) Endoscopic third ventriculostomy and repeat endoscopic third ventriculostomy in pediatric patients: the Dutch experience. J Neurosurg Pediatr 20(4):314–323
doi: 10.3171/2017.4.PEDS16669
pubmed: 28708018
Moreira I, Pereira J, Oliveira J, Salvador SF, Vaz R (2016) Endoscopic re-opening of third ventriculostomy: Case series and review of literature. Clin Neurol Neurosurg 145:58–63
doi: 10.1016/j.clineuro.2016.04.007
pubmed: 27088221
Bouras T, Sgouros S (2012) Complications of endoscopic third ventriculostomy: a systematic review. Acta Neurochir Suppl 113:149–153
doi: 10.1007/978-3-7091-0923-6_30
pubmed: 22116442
Jung TY, Chong S, Kim IY, Lee JY, Phi JH, Kim SK et al (2017) Prevention of complications in endoscopic third ventriculostomy. J Korean Neurosurg Soc 60(3):282–288
doi: 10.3340/jkns.2017.0101.014
pubmed: 28490153
pmcid: 5426448
Baroncini M, Kuchcinski G, Le Thuc V, Bourgeois P, Leroy HA, Baille G et al (2019) Is endoscopic third ventriculostomy safe and efficient in the treatment of obstructive chronic hydrocephalus in adults? A prospective clinical and MRI study. Acta Neurochir (Wien) 161(7):1353–1360
doi: 10.1007/s00701-019-03932-2
pubmed: 31069530
Sadashiva N, Shukla D, Gupta A (2023) Endovascular management of a basilar artery pseudoaneurysm after iatrogenic injury during endoscopic third ventriculostomy: case report. Acta Neurochir Suppl 130:95–101
doi: 10.1007/978-3-030-12887-6_12
pubmed: 37548728
Zhang M, Hu Y, Song D, Duan C, Wei M, Zhang L et al (2022) Exploring the prognostic differences in patients of Chiari malformation type I with syringomyelia undergoing different surgical methods. Front Neurol 13:1062239
doi: 10.3389/fneur.2022.1062239
pubmed: 36686516
Chalmers TC, Frank CS, Reitman D (1990) Minimizing the three stages of publication bias. JAMA 263(10):1392–1395
doi: 10.1001/jama.1990.03440100104016
pubmed: 2406473