Treatment Of Colloid Cysts Research Articles

A Review of Microsurgery Versus Endoscopy: Controversies for Treatment of Colloid Cysts

Background: There is controversy about the value of endoscopic methods compared to microsurgical methods in the treatment of challenging colloidal cysts. This study aimed to review the findings of literature which studied microsurgery or neuroendoscopy in the colloid cyst. Methods: An advanced search in PubMed, Science Direct, and Google Scholar databases performed using keywords such as: "microsurgery," "endoscopy," "microsurgery versus endoscopy," and "colloid cysts." Results: Reviewing the findings of related studies showed some differences in sections of surgical management, microsurgery, endoscopy, complete cyst resection, recurrence rate, length of stay, and complications between the two surgical methods in the treatment of colloid cyst. Conclusion: Despite some disadvantages of endoscopy, it seems this method has more privileges than the other methods.

Endoscopic Management of Colloid Cysts

Advances in endoscopic technology have increased the treatment options for patients with colloid cysts of the third ventricle. The endoscopic technique used by the two neurosurgeons (KAS and PN) who perform most of the colloid cyst resections at our institution is presented. Technical nuances, such as the use of stereotactic navigation for optimal bur hole placement and novel techniques for endoscopic tissue removal, are discussed. Although early series of endoscopic resections are only now obtaining 10 years of follow-up, recurrence rates appear to be low. Intracranial endoscopy has enhanced the treatment of colloid cysts by shortening operative times and hospital stays. It appears to be a safe and effective alternative to open microsurgical resection.

Early recurrence from stereotactic aspiration ofa colloid cyst of the third ventricle

The case of a 66 year old woman who underwent successful stereotactic aspiration of a symptomatic colloid cyst of the third ventricle, but who had recurrence after only 5 weeks, is presented. Stereotactic aspiration is a well established technique for th e treatment of colloid cysts, however disagreement exists regarding its efficacy. Two factors, both from pre-operative CT, help to predictsuccess from aspiration: the cyst's density and size. The literature reports that recurrence after successful stere otactic aspiration should not occur for many years.

Interactive image-guided transcallosal microsurgery for anterior third ventricular cysts.

Although the treatment of colloid cysts remains controversial, high viscosity and small volume are poor prognostic indicators for successful burr hole aspiration and cortical incision via craniotomy may be associated with postoperative epilepsy. The anterior transcallosal approach provides a direct and adequate pathway to the lateral ventricles, where the foramen of Monro serves as a natural entrance into the anterior third ventricle, especially when the foramen is dilated by a lesion. When the midsuperior portion of the IIIrd ventricle cannot be reached, the interforniceal or the subchoroidal exposures have been advocated. Stereotactic techniques contribute to a minimal invasive approach and reduce morbidity. Nine patients harbouring anterior third ventricular cysts (seven colloids and two intrinsic craniopharyngiomas) underwent anterior transcallosal microsurgical excision assisted by an interactive infrared-based image guided system (EasyGuide, Neuro, Philips). There were 4 men and 5 women ranging in age from 15 to 42 years (mean 28.5). Transcallosal transforaminal (5 cases) or interforniceal (4 cases) approaches allowed total excision in eight patients and subtotal in one. Postoperative morbidity included a case of transient hemiparesis and a case of transient short-term memory disturbances; both resolved in the first months. Mortality was zero. Particular advantages of the method were accurate trajectory and position of callosotomy incision determination, visualisation and avoidance of superior saggital sinus, retraction of bridging veins and the often variable pericallosal arteries, spatial orientation within the ventricular system, and identification of the periventricular anatomical structures.

Colloid cysts of the third ventricle.

Since computerized tomography scanning became available at the Division of Neurosurgery in July, 1979, 13 patients have undergone removal of colloid cysts of the third ventricle by transfrontal or transcallosal routes. Computerized tomography has increased the number of colloid cysts detected in the foramen of Monro during neurological diagnostic workups. The clinical and diagnostic aspects and changing concepts in the treatment of colloid cysts are reviewed.