Endoscopic management of third ventricular colloid cysts: Eight years′ institutional experience and description of a new technique

Abstract

The operative approaches for colloid cyst excision are varied with open microsurgical excision still being considered as the "gold standard". Endoscopic removal of these cysts is gaining in popularity. To document the efficacy and safety of the endoscope for colloid cyst excision. Retrospective study of all the patients who underwent endoscopic colloid cyst excision between January 2000 and March 2009. Patient records, radiological images and operative notes were assessed. Follow-up data including clinical and radiological details were retrieved. Fifty-nine cases underwent endoscopic surgery during the study period. Gross total excision of cyst (with small residual nubbin) could be achieved in 46 (78%) patients. Others patients underwent: near-total excision (seven); partial excision (five); and cyst aspiration (one). A two-port technique for achieving excision was used in 18 patients. There was one death due to fulminant meningitis. No patients had recurrence, follow-up till 99 months. Two patients required ventriculo peritonealshunt for persistent hydrocephalus. Endoscopic excision is a safe and effective, minimally invasive method for colloid cyst removal. Even a subtotal excision of these slow-growing cysts may be acceptable when experience with the endoscope is limited.