An endoscope being used to make a hole in the ventricle so the patient can avoid needing a shunt.
For a small number of children, an endoscopic third ventriculostomy (ETV) surgery may be a treatment option. This surgery replaces the need for a shunt. Most often it’s done in children who have a narrow or blocked channel leading out of their ventricles (aqueductal stenosis). Depending on your child’s brain structures and age, the neurosurgeon may talk with you about doing an ETV instead of putting in a shunt.
During an ETV, the neurosurgeon:
- Makes a small hole in your child’s skull
- Uses a rigid endoscope to go into the third ventricle and make a hole in the bottom of it
CSF flows out of this hole and reaches the normal places around the brain where it is absorbed.
Children who have an ETV may avoid complications that can happen with shunts, such as infections or needing a shunt replaced (shunt revision). In carefully selected patients, ETV has a high success rate. But some children who have an ETV need to have a shunt put in later.