gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Long-term results of endoscopic treatment of arachnoid cysts

Meeting Abstract

  • C. Vorbau - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald
  • J. Baldauf - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald
  • M.J. Fritsch - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald
  • J. Oertel - Klinik für Neurochirurgie, Universitätklinikum des Saarlandes, Homburg/Saar
  • M.R. Gaab - Neurochirurgische Klinik, Krankenhaus Nordstadt, Klinikum Region Hannover GmbH
  • H.W.S. Schroeder - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.03.09

DOI: 10.3205/11dgnc009, URN: urn:nbn:de:0183-11dgnc0094

Veröffentlicht: 28. April 2011

© 2011 Vorbau et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: The aim of this prospective study was to evaluate the long-term results after endoscopic treatment of arachnoid cysts.

Methods: 34 patients underwent endoscopic or endoscope-assisted treatment of arachnoid cysts in our department over a period of 14 years (1993–2007). The current contact address of 26 patients could be obtained and 26 of these patients (15 female, 11 male) agreed with a follow-up examination. The age of the patients at the time of treatment ranged from 11 months to 75 years (average 32.3 years). The location of the cysts was sylvian (13), suprasellar (5), velum interpositum (2), infratentorial (2), intraventricular (2), temporo-parietal (1) and one in the internal auditory canal. The patient’s symptoms included headache, nausea and vomiting, dizziness, impaired consciousness up to the point of syncope, seizure, imbalance, hypacusis, tinnitus, impaired vision, diplopic images, paraesthesia, paresis, speech disorder, behavioural disorder, lack of concentration, precocious puberty, and pathological skull growth. Endoscopic techniques included cystocisternostomies (15), ventriculocystostomies (6), ventriculocystocisternostomies (4) and partial resection (1). In 5 operations, a permanent catheter was used to keep the fenestration hole open. In 6 patients, an endoscope-assisted microsurgical technique was used.

Results: There was no mortality and no permanent morbidity. In 8 of 26 procedures temporary complications occurred as meningitis-like-symptoms without positive cultures (6), incomplete trochlear nerve (1) and facial nerve paresis (1), chronic subdural haematoma (1) and cerebrospinal fluid fistula (1). Symptoms were completely relieved in 7 patients, improved markedly in 16 cases and remained constant in one case. The average follow up period was 101.2 months ranging from 26 to 197 months. Two patients died during the period of follow-up because of problems not related to the cysts. In 24 patients, MR imaging was performed. 22 cysts decreased in size, one cyst increased in size and one remained stabile in size. In two patients, an endoscopic revision was required because the first endoscopic attempt failed. After the second surgery, the cysts decreased in size. There was only one case in which the endoscopic treatment failed.

Conclusions: Endoscopic surgery is a safe and effective treatment option in arachnoid cysts providing excellent long-term results.