Preresectional endoscopic third ventriculostomy in the management of pediatric posterior fossa tumors.

Abstract

e12520 Background: Most children with posterior fossa tumors have clinically-important hydrocephalus at presentation. Traditionally, many of them are treated with ventriculo-peritoneal (VP) shunting prior to tumor resection. There are on-going debates about the efficacy of pre-resectional endoscopic third ventriculostomy (ETV) in the care of these patients. This study evaluates the usefulness of ETV in this category of children as presented in current global literature. Methods: A PUBMED search was performed for studies reporting the use of ETV in the management of hydrocephalus prior to tumor resection in children with posterior fossa tumors. Data on the success rates of ETV as well as its complications were collated and analyzed. Results: Nine studies from diverse geographical areas were identified. A total of 224 children were studied. The average reported success rate was 89.7%(range: 65.0% - 100.0%). The reported complications were meningitis, intraventricular hemorrhage, CSF leak, reversed herniation and orbital emphysema in 2, 4, 1, 1, and 1 patient(s) respectively. There was no reported mortality. Conclusions: ETV is useful in the treatment of hydrocephalus prior to tumour resection in children with posterior fossa tumor. Its high sucess rates and extremely low morbidity rates make it ideal for symptomatic control before definitive tumor surgery in the pediatric population.