To investigate the therapeutic effect and complications of endoscopic third ventriculostomy (ETV) in children with obstructive hydrocephalus caused by posterior fossa tumors.

A retrospective study was conducted on the clinical data of 92 children with posterior fossa tumors admitted to the Department of Neurosurgery, Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from September 2013 to September 2021. All children had symptoms of intracranial hypertension caused by obstructive hydrocephalus and procedures was performed in two stages (ETV first and tumor resection second). Postoperative efficacy and incidence of complications of ETV and recurrence rate of hydrocephalus post tumor resection were determined.

ETV was successfully completed in 98.9% (92/93) of all patients and the symptoms of intracranial hypertension were relieved after ETV. ETV failed in 1 case due to intracranial bleeding. The symptoms of intracranial hypertension were relieved after ETV in all cases. There was 1 case of intracranial infection after operation, which was cured by anti-infection therapy. The complication rate was 1.1% (1/92). The recurrence rate of hydrocephalus was 6.5% (6/92). In all cases of current hydrocephalus, the hydrocephalus was relieved after reoperation and placement of a ventriculoperitoneal shunt.

For children with posterior fossa tumors complicated with obstructive hydrocephalus in need of emergency relief of intracranial hypertension, ETV treatment can relieve the symptoms of intracranial hypertension in time, with few complications and a low recurrence rate of hydrocephalus after tumor resection.

Hydrocephalus; Treatment outcome; Postoperative complications; Endoscopic third ventriculostomy; Brain neoplasms; Cranial fossa, posterior