Comparison of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: A retrospective study

Objective: Ventriculoperitoneal shunt (VPS) is used in the treatment of normal pressure hydrocephalus. Endoscopic third ventriculostomy (ETV) has started to be applied as an alternative treatment option. The aim of this study is to compare the efficacy and complication rates of the two treatments and to determine which treatment modality (VPS/ETV) has a high treatment efficiency and a low complication rate in INBH. Materials and Methods: 58 patients diagnosed with INBH were included. VPS was applied to 35 patients. ETV was applied to 23 patients. Benefit and complication rates from the operation were evaluated. Comparisons were made with the Statistical Package for the Social Sciences (SPSS). A reduction of two units in the postoperative INBHES score of the patients was considered as the primary benefit. Results: While clinical improvement was 68.6% in VPS patients, 43.5% in ETV patients. The difference between them was not significant. (p= 0,151) Complication rates are; While it was 27.5% in VPS applied patients, it was 4.3% in ETV applied patients. The difference between them was statistically significant. (p= 0,042) Conclusion: ETV can be considered as an alternative treatment option to VPS in INBH patients. Nevertheless, there is a need for controlled prospective randomized studies comparing the application of ETV and VPS in patients with INH in order to be able to state the treatment superiority of ETV over VPS.