Transcortical removal of third ventricular colloid cysts: a comparison of conventional, guided microsurgical and endoscopic approaches and a review of the literature

Abstract

ABSTRACTdevelopment of the central nervous system (35). Although colloid cysts are benign tumors, they may continue to enlarge to occlude the foramen of Monro and are known to lead to sudden death (9,21,39).Standard surgical approaches for the removal of CC traverse either the corpus callosum or the frontal cortex. RESUlTS:Ages ranged between 16 and 66 years (mean: 36.8). There were 18 female and 23 male patients. Headache was the main presenting symptom. The mean CC diameter was 15.5 mm. Intraventricular hemorrhage was encountered in 2 patients. Three patients needed postoperative ventriculoperitoneal shunt surgery. Postoperative seizures were seen in 3, postoperative neurological deficit in 3 and residual tumor in 2 patients. The conventional approach resulted in significantly higher rates of postoperative seizure compared to the minitubular and endoscopic approaches (p=0.012). The rate of residual cyst was significantly higher in endoscopic approach compared to conventional and minitubular approaches (p=0.024). Conventional approach led to significantly higher rates of neurological deficit compared to the two other approaches (p<0.05). CONClUSION:With respect to complication rates, the stereotactic and endoscopic approaches are both safe and reliable compared to conventional microsurgical approach that has unacceptably high rates of seizures and neurological deficit. Concerning completeness of removal, both microsurgical approaches are by far superior to neuroendoscopy. The stereotactic microsurgical approach compares favorably in both respects with endoscopic and conventional microsurgical approaches.

Safety and Efficacy of Neuronavigation via Middle Frontal Gyrus Endoport-assisted Endoscopic Resection for Thalamic Lesions

“…It provides a closer and broader exposure to the anatomical structure but minor damage to the brain parenchyma. The fact that no serious postoperative complications occurred in patients with benign lesions and low-grade glioma can reasonably verify this, although the incidence here is higher than 15% reported in previous studies [23,24].…”

The endoport-assisted neuroendoscopic techniques used in resection of intraventricular lesions

“…The use of endoport as a neurosurgical tubular working cannula and a retractor can be traced to 1988 when Kelly et al reported using stereotactic tubular retractors to resect deep lesions in the brain and hippocampus and amygdala since 1984 (18). Subsequently, many researchers reported similar surgeries in which tubular cannulas were used to resect intracranial lesions under stereotactic systems (3,22,26), including the combined use of endoscopy. With the development of frameless navigation techniques, tubular cannulas have been increasingly used.…”

Keyhole Approach for Microscopic Excision of Third Ventricular Colloid Cyst: Our Experience

“…Shaikh AB in 2014 studied 1278 patients of colloid cyst and did a met analysis on both types of approach as endoscopic versus microscopic [2]. Spanchi PA in 2017 further studied their group of patients undergoing microsurgical and endoscopic approach es [3]. Cohen Gadol in 2013 described minitubular approach for colloid cyst excision [4].…”