Abstract
BackgroundThe aim of this study was to assess the effectiveness of neuroendoscopy compared with non-neuroendoscopic procedures for treating patients with arachnoid membrane cysts in the lateral ventricles.MethodsThe medical records of 28 patients with arachnoid membrane cysts in the lateral ventricles who were treated with neuroendoscopy and 39 such patients treated with non-neuroendoscopic techniques using classic treatment procedures were reviewed. The neuroendoscopic approach combined craniotomy, corticectomy, lesion resection and cyst ventriculostomy or cyst cisternostomy to restore normal cerebrospinal fluid circulation. The non-neuroendoscopic techniques included craniotomy, corticectomy, and lesion resection performed under a microscope. Clinical outcomes of symptoms and cyst size change on imaging were compared between the two treatment groups during follow-up (range: 1–5 years).ResultsPatients in the neuroendoscopy group had significantly less blood loss (P < 0.001) and shorter operative time (P < 0.001), better marked improvement in symptoms (64.3% vs. 5.1%, respectively), and a higher total resection rate (92.9% vs. 66.7%; P = 0.011) compared with the patients in the non-neuroendoscopy group. In the neuroendoscopy group there was no cyst recurrence whereas in the non-neuroendoscopy group 8 (20.5%) patients had cyst recurrence. However, all patients in the neuroendoscopy group had postoperative transient fever and 8 (28.6%) patients had subdural fluid accumulation which was treated and subsequently resolved during follow-up. These symptoms did not occur in the non-neuroendoscopy group.ConclusionWe found that neuroendoscopic therapy for arachnoid cysts in the lateral ventricles was more efficacious than non-neuroendoscopic methods. Our results indicate that neuroendoscopy may produce better clinical outcomes than non-neuroendoscopic procedures in treating patients with arachnoid cysts in the lateral ventricles.
Highlights
The aim of this study was to assess the effectiveness of neuroendoscopy compared with nonneuroendoscopic procedures for treating patients with arachnoid membrane cysts in the lateral ventricles
There have been only a few studies that assessed the use of neuroendoscopy for treating lateral ventricular cysts [12,13,14,15]
The results showed that the average hospital stay following treatment of colloid cysts of the lateral and third ventricles by neuroendoscopy was 2.3 days compared to 5 days following craniotomy [8]
Summary
The aim of this study was to assess the effectiveness of neuroendoscopy compared with nonneuroendoscopic procedures for treating patients with arachnoid membrane cysts in the lateral ventricles. Cysts are amenable to the neuroendoscopic approach because they are not difficult to aspirate and their walls are easy to ablate or resect [3,4]. The cysts are formed from duplication or spitting of the arachnoid layer [16] Because these cysts are located in the lateral ventricles they block the cerebrospinal fluid circulation route, thereby producing elevated intracranial pressure. The purpose of this study was to retrospectively analyze the clinical outcomes of neuroendoscopic surgery versus non-neuroendoscopic surgical methods for patients with arachnoid membrane cysts in the lateral ventricles
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