Application of retroauricular external ventricular drainage in the treatment of pyogenic ventriculitis

LV Xing; ZHANG Fan; LIU Xi; LI Mingze; WANG Junwei; LIU Li

doi:10.11850/j.issn.1009-122X.2025.12.005

Abstract：Objective To investigate the efficacy and safety of retroauricular external ventricular drainage(RaEVD)in the treatment of pyogenic ventriculitis(PV).Methods The clinical data of 7 patients with PV who underwent a total of 9 RaEVD procedures were analyzed retrospectively.On the basis of conventional external ventricular drainage(EVD),an FR10 diameter drainage tube was placed in the hairless area behind the ear via a subcutaneous tunnel,with a tunneling distance of 15-20 cm from the frontal region and 12-15 cm from the occipital region.The catheter indwelling duration,the incidence of new infections,complications,whether ventriculoperitoneal shunt(VPS)was performed,and the modified Rankin scale(mRS)scores before and after surgery were statistically analyzed.Results The median RaEVD drainage duration was 23 days(range:12-39 days).One case(1/7)developed intraventricular hemorrhage.There were no cases of catheter obstruction,drainage-related infections,or cerebrospinal fluid leakage.Six patients underwent VPS after surgery.The median follow-up time was 10 months(range:1-19 months).The median mRS score decreased from 4 preoperatively to 1 postoperatively.Four patients(4/7)had a favorable outcomes(mRS 0-1),and one(1/7)had poor outcomes(mRS 4),while 2 patients(2/7)died due to disease deterioration.Conclusions RaEVD offers a long catheter indwelling duration,,a low risk of catheter obstruction,and a high effecacy rate in the treatment of PV.It is a simple procedure and can serve as an adjuvant or alternative approach.Subsequent studies with larger sample sizes and longer follow-up periods are needed to validate its safety and efficacy.