PURPOSE: In the current literature, there are essentially no comparisons of 
quality of life (QOL) outcome after endoscopic third ventriculostomy (ETV) and 
shunt in childhood hydrocephalus. Our objective was to compare QOL in children 
with obstructive hydrocephalus, treated with either ETV or shunt.
METHODS: A cross-sectional survey was conducted at SickKids, Toronto of children 
between ages five and 18 years, with obstructive hydrocephalus due to aqueductal 
obstruction and no other brain abnormalities. Measures of QOL were the 
Hydrocephalus Outcome Questionnaire and the Health Utilities Index Mark 3. A 
subset of patients was given the Wechsler Intelligence Scales for Children 
(WISC-IV).
RESULTS: A total of 47 of 59 (80%) eligible patients participated (24 had ETV as 
primary treatment, 23 had shunt as primary treatment), with a mean age of 12.1 
years (standard deviation 3.9) at assessment. The ETV group was older at initial 
surgery (p < 0.001) and had larger ventricle size at last follow-up (p = 0.047). 
In all QOL measures, there were no significant differences between the ETV group 
and shunt group (all p > or = 0.09). Treatment failure, hydrocephalus 
complications, and the presence of a functioning ETV at assessment were not 
associated with QOL differences. Among the 11 children (six ETV, five shunt) who 
were given the WISC-IV, there were no significant differences between the scores 
of the ETV group and shunt group (all p > or = 0.11).
CONCLUSIONS: This is the first study to provide a meaningful comparison of QOL 
after ETV and shunt in children. These preliminary results suggest that there is 
no obvious difference in QOL after ETV and shunt.