• Ann Marie Flannery, Ann-Christine Duhaime, Mandeep S Tamber, Joanna Kemp, and Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force.
• Department of Neurological Surgery, Saint Louis University, St. Louis, Missouri
• J Neurosurg Pediatr. 2014 Nov 1;14 Suppl 1:24-9.

ObjectThis systematic review was undertaken to answer the following question: Do technical adjuvants such as ventricular endoscopic placement, computer-assisted electromagnetic guidance, or ultrasound guidance improve ventricular shunt function and survival?MethodsThe US National Library of Medicine PubMed/MEDLINE database and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words specifically chosen to identify published articles detailing the use of cerebrospinal fluid shunts for the treatment of pediatric hydrocephalus. Articles meeting specific criteria that had been delineated a priori were then examined, and data were abstracted and compiled in evidentiary tables. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider evidence-based treatment recommendations.ResultsThe search yielded 163 abstracts, which were screened for potential relevance to the application of technical adjuvants in shunt placement. Fourteen articles were selected for full-text review. One additional article was selected during a review of literature citations. Eight of these articles were included in the final recommendations concerning the use of endoscopy, ultrasonography, and electromagnetic image guidance during shunt placement, whereas the remaining articles were excluded due to poor evidence or lack of relevance. The evidence included 1 Class I, 1 Class II, and 6 Class III papers. An evidentiary table of relevant articles was created. CONCLUSIONS/RECOMMENDATION: There is insufficient evidence to recommend the use of endoscopic guidance for routine ventricular catheter placement.Strength Of RecommendationLevel I, high degree of clinical certainty.RecommendationThe routine use of ultrasound-assisted catheter placement is an option.Strength Of RecommendationLevel III, unclear clinical certainty.RecommendationThe routine use of computer-assisted electromagnetic (EM) navigation is an option.Strength Of RecommendationLevel III, unclear clinical certainty.

28 keywords...

hide…