title: Endoscopic third ventriculostomy before tumor surgery in children with posterior fossa tumors, CCHE experience.
abstract: OBJECTIVE
  This is a retrospective study to evaluate the effectiveness of endoscopic third ventriculostomy (ETV) performed in children with posterior fossa tumors and hydrocephalus in an attempt to classify the selected cases who could benefit from ETV as a permanent CSF diversion procedure.
  
  
  METHODS
  During the period between January 2008 and December 2008, 40 patients with posterior fossa tumors and associated hydrocephalus were treated inside the Children's Cancer Hospital, Egypt (CCHE)-with ETV in order to relieve the increased intracranial pressure while awaiting their definite tumor surgery.
  
  
  RESULTS
  ETV was successful in relieving hydrocephalus clinically and radiologically in 26 patients with different posterior fossa pathologies, with the highest success rate in glioma (100%), followed by 50% in ependymoma and 47.6% in medulloblatoma. In the other 14 cases, preoperative ETV failed in permanently resolving hydrocephalus and patients required the insertion of a ventriculoperitoneal (VP) shunt after their posterior fossa surgery and during their follow-up period.
  
  
  CONCLUSIONS
  ETV should be considered as an alternative procedure to VP shunt in controlling severe hydrocephalus related to posterior fossa tumors, to relieve symptoms quickly during the preoperative period while patients await their definite tumor excision. Patients with ependymomas and gliomas, with totally excised tumors, are better candidates for ETV than those with medulloblastomas. However, ETV cannot always prevent postoperative hydrocephalus in all cases of posterior fossa tumor, the thing that makes using postoperative VP shunt an alternative.
authors.affiliation: Department of Neurosurgery, Cairo University Hospital, Children's Cancer Hospital (57357), Cairo, Egypt. Beltagy_mohamed@hotmail.com
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: El Beltagy
authors.forename: Hazem Mostafa
authors.initials: HM
authors.lastname: Kamal
authors.forename: Hala
authors.initials: H
authors.lastname: Taha
authors.forename: Madeha
authors.initials: M
authors.lastname: Awad
authors.forename: Nada
authors.initials: N
authors.lastname: El Khateeb
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D015192:Infratentorial Neoplasms / Q000150:complications / Q000601:surgery*; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D020542:Third Ventricle / Q000601:surgery; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*