External drainage with an Ommaya reservoir for perioperative hydrocephalus in children with posterior fossa tumors

Childs Nerv Syst. 2013 Aug;29(8):1293-7. doi: 10.1007/s00381-013-2078-8. Epub 2013 Mar 17.

Abstract

Purpose: This study aims to evaluate an external drainage using an Ommaya reservoir for relieving perioperative hydrocephalus and reducing postoperative complications in children with posterior fossa tumors.

Methods: We retrospectively analyzed the data from 48 children with posterior fossa tumors who underwent tumor resection between May 2006 and June 2012. An Ommaya reservoir was placed in the right lateral ventricle forehead for continuous perioperative drainage of cerebrospinal fluid (CSF).

Results: Tumors were successfully removed from all patients. Intracranial infection occurred in nine patients and was controlled by antibiotic treatment. Preoperative obstruction and obstructive hydrocephalus were relieved, and the need for a shunt or endoscopic third ventriculostomy was avoided. One patient who underwent a second surgical procedure had intracranial infection, hydrocephalus, and occipital pseudomeningocele. After continuous drainage and anti-infective treatment, hydrocephalus and intracranial infection were effectively controlled.

Conclusions: Using an Ommaya reservoir for perioperative external ventricular CSF drainage enabled tumors to be wholly and safely removed. Restoring CSF circulation provided an effective means of controlling and preventing hydrocephalus secondary to posterior fossa tumors in children.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Drainage / instrumentation*
  • Drainage / methods*
  • Female
  • Humans
  • Hydrocephalus / etiology*
  • Hydrocephalus / therapy*
  • Infratentorial Neoplasms / complications*
  • Magnetic Resonance Imaging
  • Male
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Third Ventricle / surgery*
  • Tomography, X-Ray Computed
  • Ventriculostomy / methods