Endoscopic third ventriculostomy in hydrocephalus secondary to posterior fossa tumors in adults
Keywords:
VENTRICULOSTOMY, HYDROCEPHALUS, TUMORS, CRANIAL FOSSA, POSTERIOR.Abstract
Introduction: posterior fossa tumors frequently cause obstructive hydrocephalus. There are several therapeutic schemes to manage this entity, which pursue the resolution of intracranial hypertension. Third ventricle floor fenestration is a fast and a resolution option having few postoperative complications.
Objective: to characterize the surgical results of patients undergoing surgeries for obstructive hydrocephalus secondary to posterior fossa tumors by endoscopic fenestration of the third ventricle.
Methods: an observational, descriptive, cross-sectional, case series study was carried out with an intentional sampling which considered the inclusion criteria, obtaining a sample of 6 patients.
Results: the time elapsed between diagnosis and fenestration was 24 hours. All of them showed a Glasgow scale equal to or higher than 13 points. A grade 6 on the Frisen scale was observed in only one case. On diagnostic CT images, the diameter of the third ventricle averaged 14 mm. The maximum Evans index was 0.40. The maximum time elapsed between the diagnosis of hydrocephalus and the performance of the shunt was 48 hours. The average surgical time was 32 minutes. An average of 99 hours elapsed between the first surgery and tumor resection. In the following six months, no patient presented hydrocephalus.
Conclusions: endoscopic fenestration of the third ventricle is a safe technique in the treatment of hydrocephalus due to posterior fossa tumors. Low frequency of postoperative fistula is observed when performed prior to surgery.
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