Introduction Slit ventricle syndrome (SVS) remains a challenging problem in the early shunted pediatric population. Various surgical and non-surgical treatments have been devised for this condition. However, there currently is no gold standard for its optimal management. Among various treatment modalities, sub-temporal decompression (STD) is often performed as a last resort. We present our experience of STD in pediatric patients with SVS in whom initial treatment with programmable valves and anti-syphon device were not successful. Methods This is a single center retrospective observational study and survival analysis. Patients who underwent STD for SVS were included. Pre- and post-operative imaging data and clinical outcomes were collected. Results There were twenty patients (12M, 8F) with a mean age of 9 years (SD 4) at first STD. 90% (n=18) of patients had multiple shunt revisions pre-STD. At first STD, 70% (n=14) and 30% (n=6) of patients had unilateral or bilateral STD, respectively. STD led to a reduction in the frequency of shunt revisions in 60% (n=12) of patients. The median time required before further STD, shunt surgery or cranial vault surgery was 14 months. The median time before a further STD was required (either revision or contralateral side) was 89 months. At a median follow-up of 66.5 months (range 1-159), 65% (n=13) of patients had improvement in symptoms. Conclusions A large proportion of patients with persistent SVS symptoms, refractory to multiple shunt revisions, benefitted from STD in combination with shunt optimization. It was also safe and well tolerated. Therefore, in patients who have multiple failed shunts, STD may reduce the morbidity associated with further shunt revisions and can significantly improve symptomatology.  .

中文翻译：

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儿童顽固性裂隙心室综合征的颞下减压：观察性研究和生存分析。

简介 裂隙心室综合征（SVS）对于早期分流的儿科人群来说仍然是一个具有挑战性的问题。针对这种情况，已经设计了各种手术和非手术治疗方法。然而，目前尚无最佳管理的黄金标准。在各种治疗方式中，颞下减压（STD）通常是最后的手段。我们介绍了 SVS 儿科患者的 STD 经验，这些患者使用可编程阀门和防虹吸装置进行初始治疗并不成功。方法这是一项单中心回顾性观察研究和生存分析。因 SVS 而接受 STD 的患者也被纳入其中。收集术前和术后影像数据以及临床结果。结果 20 名患者（12M，8F）首次发生 STD 的平均年龄为 9 岁（SD 4）。90% (n=18) 的患者在 STD 前接受过多次分流修复。首次 STD 时，70% (n=14) 和 30% (n=6) 的患者分别患有单侧或双侧 STD。STD 导致 60% (n=12) 患者的分流修复频率减少。进一步 STD、分流手术或颅顶手术所需的中位时间为 14 个月。需要进一步进行 STD（翻修或对侧）之前的中位时间为 89 个月。中位随访时间为 66.5 个月（范围 1-159），65% (n=13) 的患者症状有所改善。结论 大部分具有持续性 SVS 症状、多次分流修正难以治疗的患者受益于 STD 与分流优化相结合。它也是安全且耐受性良好的。因此，对于多次分流失败的患者，STD 可能会降低与进一步分流修复相关的发病率，并可以显着改善症状。。