Treatment options for third ventricular colloid cysts: comparison of open microsurgical versus endoscopic resection.

Department

Neurosurgery

Document Type

Article

Abstract

OBJECTIVE: We retrospectively reviewed our experience treating third ventricular colloid cysts to compare the efficacy of endoscopic and transcallosal approaches.

METHODS: Between September 1994 and March 2004, 55 patients underwent third ventricular colloid cyst resection. The transcallosal approach was used in 27 patients; the endoscopic approach was used in 28 patients. Age, sex, cyst diameter, and presence of hydrocephalus were similar between the two groups.

RESULTS: The operating time and hospital stay were significantly longer in the transcallosal craniotomy group compared with the endoscopic group. Both approaches led to reoperations in three patients. The endoscopic group had two subsequent craniotomies for residual cysts and one repeat endoscopic procedure because of equipment malfunction. The transcallosal craniotomy group had two reoperations for fractured drainage catheters and one operation for epidural hematoma evacuation. The transcallosal craniotomy group had a higher rate of patients requiring a ventriculoperitoneal shunt (five versus two) and a higher infection rate (five versus none). Intermediate follow-up demonstrated more small residual cysts in the endoscopic group than in the transcallosal craniotomy group (seven versus one). Overall neurological outcomes, however, were similar in the two groups.

CONCLUSION: Compared with transcallosal craniotomy, neuroendoscopy is a safe and effective approach for removal of colloid cysts in the third ventricle. The endoscope can be considered a first-line treatment for these lesions, with the understanding that a small number of these patients may need an open craniotomy to remove residual cysts.

Medical Subject Headings

Arachnoid Cysts; Brain Diseases; Corpus Callosum; Endoscopy; Female; Humans; Male; Microsurgery; Middle Aged; Neurosurgical Procedures; Retrospective Studies; Third Ventricle; Treatment Outcome

Publication Date

4-1-2007

Publication Title

Neurosurgery

ISSN

1524-4040

Volume

60

Issue

4

First Page

613

Last Page

618

PubMed ID

17415197

Digital Object Identifier (DOI)

10.1227/01.NEU.0000255409.61398.EA

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