Surgical treatment of pineal cysts in non-hydrocephalic and neurologically intact patients: selection of surgical candidates and clinical outcome

Koziarski, Andrzej; Podgórski, Andrzej; Zieliński, Grzegorz

doi:10.1080/02688697.2018.1530731

Cited by 16 publications

(19 citation statements)

References 21 publications

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“…Individual participant data was collected to organize the study characteristics table. Original languages of publications included Czech, German, and Japanese for one article each, Spanish in two publications, and English for the remainder [14,15,[20][21][22][23].…”

Section: Bibliography Detailsmentioning

confidence: 99%

“…PCs in the general population are mostly considered normal anatomical variations and the Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00381-020-04792-3) contains supplementary material, which is available to authorized users. parameters to define pathological PCs in need of treatment are currently unestablished [10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…As such, surgically treated pediatric PCs may represent a different and unique entity in clinical practice, which has not previously been properly investigated. Only a few large series on surgically treated PCs have been published in recent years [10][11][12][13][14][15][16][17][18][19][20][21][22], and no clinical study on surgically treated PCs in pediatric patients has been reported thus far. In 2013, a review on surgically treated PCs in children was performed.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review of pineal cysts surgery in pediatric patients

et al. 2020

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Introduction We present a consecutive case series and a systematic review of surgically treated pediatric PCs. We hypothesized that the symptomatic PC is a progressive disease with hydrocephalus at its last stage. We also propose that PC microsurgery is associated with better postoperative outcomes compared to other treatments. Methods The systematic review was conducted in PubMed and Scopus. No clinical study on pediatric PC patients was available. We performed a comprehensive evaluation of the available individual patient data of 43 (22 case reports and 21 observational series) articles. Results The review included 109 patients (72% females). Ten-year-old or younger patients harbored smaller PC sizes compared to older patients (p < 0.01). The pediatric PCs operated on appeared to represent a progressive disease, which started with unspecific symptoms with a mean cyst diameter of 14.5 mm, and progressed to visual impairment with a mean cyst diameter of 17.8 mm, and hydrocephalus with a mean cyst diameter of 23.5 mm in the final stages of disease (p < 0.001). Additionally, 96% of patients saw an improvement in their symptoms or became asymptomatic after surgery. PC microsurgery linked with superior gross total resection compared to endoscopic and stereotactic procedures (p < 0.001). Conclusions Surgically treated pediatric PCs appear to behave as a progressive disease, which starts with cyst diameters of approximately 15 mm and develops with acute or progressive hydrocephalus at the final stage. PC microneurosurgery appears to be associated with a more complete surgical resection compared to other procedures.

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Section: Bibliography Detailsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic review of pineal cysts surgery in pediatric patients

et al. 2020

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“…1) Contrastingly, previous studies have suggested that obstructive hydrocephalus and Parinaud`s syndrome are not required to render pineal cysts symptomatic. 8,9) Our patient had a pineal cyst larger than 30 mm in diameter and presented with severe progressing bilateral hearing impairment without obstructive hydrocephalus and Parinaud's syndrome. Moreover, there was no clear wave V in bilateral BAEPs, and it was hardly normal.…”

Section: Discussionmentioning

confidence: 87%

Reversible Hearing Impairment Due to Inferior Colliculi Compression by a Pineal Glial Cyst

Mizobuchi

Shimada

Nakajima

et al. 2021

NMC Case Report Journal

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Pineal glial cysts associated with bilateral hearing impairment are very rare. Here, we present the case of a 13-year-old boy with a pineal cyst, which caused severe bilateral hearing impairment persisting from 6 years of age. When the patient was 6 years old, the bilateral hearing acuity was about 40 dB on audiometry. Upon admission to our otolaryngology department, his audiogram revealed a bilateral worsening of the hearing acuity (80 dB). Magnetic resonance imaging (MRI) revealed an abnormal pineal cyst with tectal compression from the left with hardly normal bilateral brainstem auditory evoked potentials (BAEPs). We obtained informed consent for exploratory surgery and employed the right occipital transtentorial approach for pineal cyst removal. Based on histological examination, we diagnosed a glial cyst of the pineal gland. At 12 months postoperatively, the patient's hearing improved, showing a bilateral hearing acuity of 40 dB on audiometry. Since the auditory pathway has both crossed and uncrossed fibers at the upper pons and midbrain level, compression at the lateral lemniscus or inferior colliculus level can cause bilateral hearing impairment. In the present case, there was a possible slow pineal cyst growth that eventually compressed the upper pons to the midbrain, lateral lemniscuses, or inferior colliculi from the left side, this eventually led to bilateral hearing impairment. These findings indicate that surgery can improve hearing acuity in patients with a pineal cyst associated with progressive hearing impairment.

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“…However, at times, benign PCs are associated with various symptoms and may require microsurgical resection. [3,10,11,[13][14][15]17] We recently published our experience on the surgical management of benign PCs in a large cohort of patients. Although the limitations of a single-center, retrospective study, it provided us interesting results.…”

Section: Introductionmentioning

confidence: 99%

Functional status of surgically treated pineal cyst patients

Choque-Velasquez

Resendiz-Nieves

Baluszek

et al. 2020

Surgical Neurology International

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Background: Microsurgical removal represents a well-accepted treatment option for symptomatic benign pineal cysts (PCs). However, very few studies have quantitatively evaluated the functional status of surgically treated PC patients. Methods: A detailed analysis of preoperative, immediate postoperative, and long-term clinical and radiological characteristics was performed. The functional status of the patients was categorized using the modified Rankin scale (mRS) and the Chicago Chiari Outcome Scale (CCOS). In addition, a comparative analysis between pediatric and adult patients with PCs was carried out. Results: Overall, pediatric patients experienced better long-term mRS scores than adults. The differences between the pre-, the immediate post-, and the last postoperative mRS of the patients were statistically significant for the total population (P < 0.001). All patients obtained a CCOS of 11 or more, which reflects a good/optimal result after microneurosurgery. The type of the surgical approach was independently associated with the postoperative complications (P < 0.01), more frequently reported with the midline supracerebellar infratentorial (SCIT) approach than with its paramedian modification. Conclusion: The functional status of properly selected symptomatic patients with PCs may improve significantly after their surgical management through a paramedian SCIT approach in sitting position.

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Surgical treatment of pineal cysts in non-hydrocephalic and neurologically intact patients: selection of surgical candidates and clinical outcome

Cited by 16 publications

References 21 publications

Systematic review of pineal cysts surgery in pediatric patients

Systematic review of pineal cysts surgery in pediatric patients

Reversible Hearing Impairment Due to Inferior Colliculi Compression by a Pineal Glial Cyst

Functional status of surgically treated pineal cyst patients

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