Staged bilateral far-lateral approach for bilateral cervicomedullary junction neurenteric cysts in a 10-year-old girl

Patel, Smruti; Liu, James K.

doi:10.3171/2013.5.peds13100

Cited by 13 publications

(5 citation statements)

References 33 publications

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“…Since these cysts are benign in nature, surgical excision should be considered the first-line treatment in symptomatic patients, 19 with the surgical approach chosen to provide the best exposure for tumor resection. In the present case, the pterional transcavernous approach provided good exposure allowing gross total resection with no compromise of neurovascular structures.…”

Section: Discussionmentioning

confidence: 99%

A Neuroenteric Cyst of the Cavernous Sinus: A Case Report

et al. 2023

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Background Neuroenteric cysts (NECs) are benign lesions mostly found as intradural extramedullary lesions in the cervicothoracic spinal cord. NECs in the cavernous sinus are very rare. To the best of our knowledge, this is only the second reported case and the first in an adult. Presentation We present a left cavernous sinus NEC in a 75-year-old female with gradually worsening headache and facial pain unresponsive to medical treatment. Imaging revealed a cystic mass lesion in the left cavernous sinus encasing the distal petrosal and cavernous segment of the internal carotid artery. Initial differential diagnoses included more common pathologies located near the cavernous sinus, including cystic schwannoma, craniopharyngioma, and dermoid and epidermoid tumors. The patient underwent a left pterional craniotomy with an extradural transcavernous approach for surgical exploration and possible resection of this mass lesion. Histopathology revealed an NEC lined with benign respiratory-type epithelium. Postoperative imaging revealed gross total tumor resection. The patient remained neurologically intact with complete resolution of facial pain. Conclusion We present a rare pathology that can easily be misinterpreted as other types of lesions. NECs should be kept in mind for differential diagnosis of cavernous sinus cystic lesions. The surgical aim should be maximal safe excision.

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Section: Discussionmentioning

confidence: 99%

A Neuroenteric Cyst of the Cavernous Sinus: A Case Report

et al. 2023

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“…The surgical spaces of the two corridors exposed the cistern lateral and anterior to the cerebellum and medulla oblongata without disturbing the brain tissues, which may represent the condition of epidural manipulation to reach clivus in the far-lateral approach. When passing through the lateral edge of foramen magnum, the posterior portion of glomus jugulare and the inferior end of sigmoid sinus was involved, which has potential risk of troublesome bleeding [ 24 , 25 ]. The increasing extent of venous structures in the surgical space of corridor 2 was the most.…”

Section: Discussionmentioning

confidence: 99%

Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

Tang

Xu²,

XiaodongYuan

et al. 2022

Chin Neurosurg Jl

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Background The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of far-lateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model. Methods The 3D skull base models were constructed using MRI and CT data of 15 patients (30 sides) with trigeminal neuralgia. Surgical corridors of the far-lateral approach were simulated by triangular pyramids to represent two surgical spaces exposing bony and neurovascular tissues. Volumetric comparison of surgical anatomy was performed using pair t test. Results The morphometric results were almost the same in the two surgical spaces except the vagus nerve (CN X) exposed only in one corridor, whereas the volumetric comparison represented the statistical significant differences of surgical space and bony and neurovascular tissues involved in the two corridors (P<0.001). The differences of bony and neurovascular tissues failed to equal the difference of surgical space. Conclusions For far-lateral approach, the increase of exposure for the bony and neurovascular tissues is not necessarily matched with the increase of surgical space. The volumetric comparative analysis is helpful to provide more detailed anatomical information in the surgical design.

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“…However, extensive NCs involving a wide range of ventral skull base regions may require more complicated skull base techniques, including labyrinthectomy and ligation of the sigmoid sinus, and a combination of multiple invasive approaches, which carries a significant risk of adverse events. [ 1 , 3 , 20 , 28 , 32 , 35 ] Despite the invasiveness of skull base approaches, complete removal of the cyst wall is difficult and is associated with high recurrence rates. [ 8 , 19 , 27 , 37 ] The risk of postoperative cranial nerve complications is not negligible.…”

Section: Discussionmentioning

confidence: 99%

Combined endoscopic endonasal transtubercular and transclival approaches for large neurenteric cyst in posterior cranial fossa: A case report and literature review

Sato

Hasegawa

Shin

et al. 2021

Surgical Neurology International

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Background: Intracranial neurenteric cysts (NCs) are extremely rare tumors that more commonly involve the posterior fossa than any other cranial part. While transcranial skull base surgery has been the mainstay of treatment, the utility of endoscopic transnasal surgery (ETS) remains to be established. Case Description: We report a case of a large posterior fossa NC extensively involving the suprasellar region, cerebellopontine angle, and prepontine cistern, which we successfully resected with ETS through a combination of transtubercular and transclival routes. Before surgery, the patient presented with abducens nerve and pseudobulbar palsies, which resolved within 2 weeks postoperatively. The patient remained free from recurrence for 3 years postoperatively. Conclusion: Extended ETS may offer a minimally invasive option for the posterior fossa NC, extensively occupying the ventral space of the brainstem.

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Staged bilateral far-lateral approach for bilateral cervicomedullary junction neurenteric cysts in a 10-year-old girl

Cited by 13 publications

References 33 publications

A Neuroenteric Cyst of the Cavernous Sinus: A Case Report

A Neuroenteric Cyst of the Cavernous Sinus: A Case Report

Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

Combined endoscopic endonasal transtubercular and transclival approaches for large neurenteric cyst in posterior cranial fossa: A case report and literature review

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