gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Endoscope-assisted resection of an arachnoid cyst confined to the internal auditory canal: case report

Endoskop-assistierte Resektion einer Arachnoidalzyste im Porus acusticus internus: Fallbericht

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  • corresponding author S. Fleck - Klinik und Poliklinik für Neurochirurgie, Ernst-Moritz-Arndt-Universität Greifswald
  • J. Baldauf - Klinik und Poliklinik für Neurochirurgie, Ernst-Moritz-Arndt-Universität Greifswald
  • H.W.S. Schroeder - Klinik und Poliklinik für Neurochirurgie, Ernst-Moritz-Arndt-Universität Greifswald

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 01.2

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc219.shtml

Published: May 8, 2006

© 2006 Fleck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Objective: We report an unusual case of an arachnoid cyst confined to the internal auditory canal in a 35-year-old woman. Endoscope-assisted microsurgical technique enabled a better visualization within the internal auditory canal.

Methods: The complaints were described as a slowly progressive hypacusis over 2 years and tinnitus over 7 years. MRI revealed a cystic lesion in the internal auditory canal appearing hypointense on T1-weighted images and hyperintense on T2-weighted images suggesting an arachnoid cyst. The cyst wall was endoscope-assisted microsurgically fenestrated and partially resected via a suboccipital retrosigmoid approach.

Results: Adherent vestibular nerves fibres in the cyst wall prevented a removal of the whole cyst. The histological examination confirmed the diagnosis of AC. Arachnoid cysts are congenital lesions or may be acquired as a result of inflammation or trauma.

Conclusions: The endoscope-assisted microsurgical technique enables a safe cyst resection with better visualisation of important neurovascular structures within the internal auditory canal. Small remnants of the capsule that are firmly attached to important neurovascular structures should be left in place rather than risk neurological deficits.