Journal
WORLD NEUROSURGERY
Volume 158, Issue -, Pages E681-E688Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2021.11.046
Keywords
Arachnoid cyst; Endoscopy; Neurosurgery; Pediatric
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This study describes the clinical outcomes of an innovative minimally invasive endoscopic technique for the treatment of middle cranial fossa arachnoid cysts. The use of a mini endoscope allows for better examination and treatment of the cysts, resulting in a high success rate.
Objective: Congenital arachnoid cysts in the middle fossa accounts for 50% of all intracranial arachnoid cysts. Several management options have been described; however, no single technique has been universally adopted. We describe a series of pediatric patients with middle cranial fossa arachnoid cyst that were treated through an innovative minimally invasive endoscopic technique, along with their clinical aspects and surgical outcomes. Methods: Data from 65 patients operated between 2012 and 2018 were retrospectively analyzed. Follow-up ranged from 12 to 96 months. Clinical presentation and surgical outcomes were collected. Endoscopic cystocisternostomy was performed in all patients using a mini endoscope. Results: There were 41 male and 24 female patients, with a mean age of 5.3 years at the time of treatment. Except for 4 patients, all presented with 1 or more symptoms, and the most frequent were intracranial hypertension signs. All patients were treated with the same surgical technique, with an efficacy of 81.5%. Conclusions: Using a mini endoscope allow us to perform multiple fenestrations along the arachnoid and deeply inspect the basal cisterns, achieving a much wider communication between the cyst and subarachnoid space with a high success rate and minimal invasiveness.
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