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Child's Nervous System
Erschienen in: Child's Nervous System 1/2011

01.01.2011 | Original Paper

Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children

verfasst von: Nasser M. F. El-Ghandour

Erschienen in: Child's Nervous System | Ausgabe 1/2011

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Abstract

Object

This study compares endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of pediatric patients with marked obstructive hydrocephalus due to midline posterior fossa tumors.

Methods

Fifty-three pediatric patients with a midline posterior fossa tumor (32 medulloblastomas and 21 ependymomas) associated with marked hydrocephalus were studied. Patients were divided into two groups: group A (32 patients) operated by ETV with a mean follow-up of 27.4 months and group B (21 patients) operated by VPS with a mean follow-up of 25 months.

Results

Both procedures proved to be effective clinically and radiologically. In group A, intraoperative bleeding occurred in two cases (6.2%) and cerebrospinal fluid leakage in one case (3.1%). In group B, shunt infection occurred in two cases (9.4%), one of these two cases died 4.5 months postoperatively from ventriculitis. Subdural collection occurred in two cases (9.4%), epidural hematoma in one case (4.7%), and upward brain herniation in one case (4.7%). Endoscopic third ventriculostomy proved to be superior due to shorter duration of surgery (15 min versus 35 min), lower incidence of morbidity (9.3% versus 38%), no mortality (0% versus 4.7%), and lower incidence of procedure failure (6.2% versus 38%).

Conclusion

The shorter duration of surgery, the lower incidence of morbidity, the absence of mortality, the lower incidence of procedure failure, and the significant advantage of not becoming shunt dependent make ETV be recommended as the first choice in the treatment of pediatric patients with marked obstructive hydrocephalus due to midline posterior fossa tumors.
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Metadaten
Titel
Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children
verfasst von
Nasser M. F. El-Ghandour
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 1/2011
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-010-1263-2

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