Endoscopic Third Ventriculocisternostomy for Brainstem Tumors

Object: The authors retrospectively reviewed the charts of all patients harboring brainstem tumors treated at their institution, excluding those with tectal gliomas, who underwent an endoscopic third ventriculocisternostomy.

Methods: Endoscopic third ventriculocisternostomy was performed in 13 patients with tumors involving the brainstem: nine patients with diffuse pontine gliomas, two with posterior fossa ependymomas, one with a cervicomedullary tumor, and one with a pontine primitive neuroectodermal tumor. No technical difficulties attributable to the location of the tumors or surgery-related complications were encountered. Immediate symptomatic relief of hydrocephalus was achieved in all patients, and there was an associated decrease in steroid and analgesic agent requirements. Only one patient eventually required a shunt.

Conclusions: Endoscopic third ventriculocisternostomy can be used in the terminal treatment of patients with brainstem tumors, yielding good results without significant surgical morbidity.