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Fenestration methods for Sylvian arachnoid cysts—endoscopy or microsurgery

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Abstract

Introduction

Two different approaches to fenestration, endoscopic and microsurgical, are in use for Sylvian arachnoid cysts (SACs), the most frequent among intracranial arachnoid cysts. We presented the clinical data and compared our results, with regard to technique and clinical success, with either microsurgical or neuroendoscopic fenestration of SACs.

Materials and methods

Twenty-nine patients who subjected to cysto-cisternostomy by the same team, using either of the two methods, were studied retrospectively.

Results

Thirteen patients underwent microsurgery, and 16 had endoscopic cysto-cisternostomy. No reoperation was needed in either of these groups, i.e., full clinical and radiological success was achieved in both. The complication rate was 23% in the microsurgery patients and 47% in the endoscopic surgery group, with no statistically significant difference.

Conclusions

No relevant differences between the two methods are seen either in the published data or in our results. Adding our results to the published data, both techniques were reviewed in a discussion of the one that allows a better controlled or safer fenestration. We conclude that endoscopic fenestration of SACs is not superior to microsurgical cyst fenestration, and the latter seems safer.

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References

  1. Boutarbouch M, El Ouahabi A, Rifi L, Arkha Y, Derraz S, El Khamlichi A (2008) Management of intracranial arachnoid cysts: institutional experience with initial 32 cases and review of the literature. Clin Neurol Neurosurg 110:1–7

    Article  PubMed  Google Scholar 

  2. Caemaert J, Abdullah J, Calliauw L, Carton D, Dhooge C, van Coster R (1992) Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochir (Wien) 119:68–73

    Article  CAS  Google Scholar 

  3. Choi JU, Kim DS, Huh R (1999) Endoscopic approach to arachnoid cyst. Childs Nerv Syst 15:285–291

    Article  PubMed  CAS  Google Scholar 

  4. Cinalli G, Spennato P, Ruggiero C, Aliberti F, Trischitta V, Buonocore MC, Cianciulli E, Maggi G (2007) Complications following endoscopic intracranial procedures in children. Childs Nerv Syst 23:633–644

    Article  PubMed  Google Scholar 

  5. Decq P, Yepes C, Anno Y, Djindjian M, Nguyen JP, Kéravel Y (1994) Neurosurgical endoscopy. Diagnostic and therapeutic indications. Neurochirurgie 40:313–321

    PubMed  CAS  Google Scholar 

  6. Dhooge C, Govaert P, Martens F, Caemaert J (1992) Transventricular endoscopic investigation and treatment of suprasellar arachnoid cysts. Neuropediatrics 23:245–247

    Article  PubMed  CAS  Google Scholar 

  7. Di Rocco F, James SR, Roujeau T, Puget S, Sainte-Rose C, Zerah M (2010) Limits of endoscopic treatment of sylvian arachnoid cysts in children. Childs Nerv Syst 26:155–162

    Article  PubMed  Google Scholar 

  8. Erşahin Y, Kesikçi H, Rüksen M, Aydin C, Mutluer S (2008) Endoscopic treatment of suprasellar arachnoid cysts. Childs Nerv Syst 24:1013–1020

    Article  PubMed  Google Scholar 

  9. Fitzpatrick MO, Barlow P (2001) Endoscopic treatment of prepontine arachnoid cysts. Br J Neurosurg 15:234–238

    Article  PubMed  CAS  Google Scholar 

  10. Fries G, Perneczky A (1998) Endoscope-assisted brain surgery: part 2—analysis of 380 procedures. Neurosurgery 42:226–231, discussion 231–222

    Article  PubMed  CAS  Google Scholar 

  11. Galassi E, Piazza G, Gaist G, Frank F (1980) Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically. Surg Neurol 14:211–219

    PubMed  CAS  Google Scholar 

  12. Galassi E, Gaist G, Giuliani G, Pozzati E (1988) Arachnoid cysts of the middle cranial fossa: experience with 77 cases treated surgically. Acta Neurochir Suppl (Wien) 42:201–204

    CAS  Google Scholar 

  13. Gangemi M, Colella G, Magro F, Maiuri F (2007) Suprasellar arachnoid cysts: endoscopy versus microsurgical cyst excision and shunting. Br J Neurosurg 21:276–280

    Article  PubMed  CAS  Google Scholar 

  14. Helland CA, Lund-Johansen M, Wester K (2010) Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample. J Neurosurg 113:934–939

    Article  PubMed  Google Scholar 

  15. Hinojosa J, Esparza J, Muñoz MJ, Valencia J (2001) Endoscopic treatment of suprasellar arachnoid cysts. Neurocirugia (Astur) 12:482–488, discussion 489

    CAS  Google Scholar 

  16. Hopf NJ, Perneczky A (1998) Endoscopic neurosurgery and endoscope-assisted microneurosurgery for the treatment of intracranial cysts. Neurosurgery 43:1330–1336, discussion 1336–1337

    PubMed  CAS  Google Scholar 

  17. Kang JK, Lee KS, Lee IW, Jeun SS, Son BC, Jung CK, Park YS, Lee SW (2000) Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children. Childs Nerv Syst 16(2):111–116

    Article  PubMed  CAS  Google Scholar 

  18. Karabatsou K, Hayhurst C, Buxton N, O’Brien DF, Mallucci CL (2007) Endoscopic management of arachnoid cysts: an advancing technique. J Neurosurg 106:455–462

    Article  PubMed  Google Scholar 

  19. Kirollos RW, Javadpour M, May P, Mallucci C (2001) Endoscopic treatment of suprasellar and third ventricle-related arachnoid cysts. Childs Nerv Syst 17:713–718

    Article  PubMed  CAS  Google Scholar 

  20. Lange M, Oeckler R (1987) Results of surgical treatment in patients with arachnoid cysts. Acta Neurochir (Wien) 87:99–104

    Article  CAS  Google Scholar 

  21. Maher CO, Goumnerova L (2011) The effectiveness of ventriculocystocisternostomy for suprasellar arachnoid cysts. J Neurosurg Pediatr 7:64–72

    Article  PubMed  Google Scholar 

  22. Mamelak AN, Danielpour M, Black KL, Hagike M, Berci G (2008) A high-definition exoscope system for neurosurgery and other microsurgical disciplines: preliminary report. Surg Innov 15(1):38–46

    Article  PubMed  Google Scholar 

  23. Oertel JM, Baldauf J, Schroeder HW, Gaab MR (2009) Endoscopic cystoventriculostomy for treatment of paraxial arachnoid cysts. J Neurosurg 110:792–799

    Article  PubMed  Google Scholar 

  24. Oertel JM, Wagner W, Mondorf Y, Baldauf J, Schroeder HW, Gaab MR (2010) Endoscopic treatment of arachnoid cysts: a detailed account of surgical techniques and results. Neurosurgery 67:824–836

    Article  PubMed  Google Scholar 

  25. Pei A, Zhang YZ, Zong XY, Wang XS, Song M (2007) Endoscopic treatment of suprasellar arachnoid cysts. Zhonghua Yi Xue Za Zhi 87:311–314

    PubMed  Google Scholar 

  26. Perneczky A, Fries G (1998) Endoscope-assisted brain surgery: part 1—evolution, basic concept, and current technique. Neurosurgery 42:219–224, discussion 224–215

    Article  PubMed  CAS  Google Scholar 

  27. Raffel C, McComb JG (1988) To shunt or to fenestrate: which is the best surgical treatment for arachnoid cysts in pediatric patients? Neurosurgery 23:338–342

    Article  PubMed  CAS  Google Scholar 

  28. Sato H, Sato N, Katayama S, Tamaki N, Matsumoto S (1991) Effective shunt-independent treatment for primary middle fossa arachnoid cyst. Childs Nerv Syst 7:375–381

    Article  PubMed  CAS  Google Scholar 

  29. Schroeder HW, Oertel J, Gaab MR (2004) Incidence of complications in neuroendoscopic surgery. Childs Nerv Syst 20:878–883

    Article  PubMed  Google Scholar 

  30. Shim KW, Lee YH, Park EK, Park YS, Choi JU, Kim DS (2009) Treatment option for arachnoid cysts. Childs Nerv Syst 25:1459–1466

    Article  PubMed  Google Scholar 

  31. Sood S, Schuhmann MU, Cakan N, Ham SD (2005) Endoscopic fenestration and coagulation shrinkage of suprasellar arachnoid cysts. Technical note. J Neurosurg 102:127–133

    PubMed  Google Scholar 

  32. Tamburrini G, Caldarelli M, Massimi L, Santini P, Di Rocco C (2003) Subdural hygroma: an unwanted result of Sylvian arachnoid cyst marsupialization. Childs Nerv Syst 19:159–165

    PubMed  CAS  Google Scholar 

  33. Wang JC, Heier L, Souweidane MM (2004) Advances in the endoscopic management of suprasellar arachnoid cysts in children. J Neurosurg 100:418–426

    PubMed  Google Scholar 

  34. Wester K, Svendsen F, Hugdahl K (1999) Intracranial arachnoidal cysts—localization, gender and sidedness. Tidsskr Nor Laegeforen 119:4162–4164

    PubMed  CAS  Google Scholar 

  35. Yadav YR, Parihar V, Sinha M, Jain N (2010) Endoscopic treatment of the suprasellar arachnoid cyst. Neurol India 58(2):280–283

    Article  PubMed  CAS  Google Scholar 

  36. Zada G, Krieger MD, McNatt SA, Bowen I, McComb JG (2007) Pathogenesis and treatment of intracranial arachnoid cysts in pediatric patients younger than 2 years of age. Neurosurg Focus 22:E1

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Medicine, Department of Neurosurgery, Ege University, Izmir, Turkey

    Tuncer Turhan, Yusuf Erşahin, Nevhis Akıntürk & Saffet Mutluer

  2. Beyin Cerrahisi ABD, Ege Universitesi, Bornova, Izmir, 35100, Turkey

    Tuncer Turhan

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  1. Tuncer Turhan
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  2. Yusuf Erşahin
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  4. Saffet Mutluer
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Correspondence to Tuncer Turhan.

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Turhan, T., Erşahin, Y., Akıntürk, N. et al. Fenestration methods for Sylvian arachnoid cysts—endoscopy or microsurgery. Childs Nerv Syst 28, 229–235 (2012). https://doi.org/10.1007/s00381-011-1487-9

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  • DOI: https://doi.org/10.1007/s00381-011-1487-9

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