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International Journal of Neurology and Neurosurgery

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Neuroendoscopic Excision of Third Ventricular Colloid Cysts

Sarang Gotecha, Assistant Professor, Department of Neurosurgery, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, Maharashtra 411018, India. , Ashish Chugh1 , Mazhar Husain2 , Manu Rastogi3 , Sarang Gotecha4 , Prashant Punia5 , Anil Patil6

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International Journal of Neurology and Neurosurgery 10(4):p 157-164, Oct-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10418.11

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Abstract

  Objective: Several surgical approaches have been proposed for the treatment of colloid cysts, which still remains controversial. Though microsurgical craniotomy is more apt to result in a gross total resection, yet subtotal resections and recurrences occur even with best possible efforts. Off late, endoscopy is emerging as an effective alternative to address various intraventricular lesions. Methods: The study was carried out on 23 patients (Males-14, Females-9) spanning over a period of 8 years. The age group of the patients ranged from 16years-60 years. Depending on the radiological appearance, the procedure was performed via a right or left precoronal burr hole. We aimed for complete resection of the entire cyst, including the cyst wall. Only in situations in which a part of the cyst wall could not be separated from neural or vascular structures, it was coagulated and left in situ. Results: The Follow-up period ranged from a period of 2 months-96 months. All patients were operated by precoronal uniportal transventricular technique without using any navigation system. Twenty two patients were operated by transforaminal approach. One patient required trans-septal approach. Complete excision was possible in 20 cases, while in three patients a small part of cyst was left to avoid venous injury. The operative time ranged between 45 to 100 minutes. Resolution of the symptoms was obtained in all our patients without any mortality. Conclusion: These results show that endoscopy is a safe and effective alternative to the well established approaches of microsurgical removal and stereotactic aspiration with a quicker return to active life and low or negligible direct surgical morbidity. 

Keywords: Neuroendoscopic Excision; Craniotomy; Colloid Cysts.

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10418.11

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