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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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Endoscopic treatment of arachnoid cysts: experience with 32 cases

Die endoskopische Behandlung von Arachnoidalzysten: Erfahrungen mit 32 Fällen

Meeting Abstract

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  • corresponding author J. Oertel - Department of Neurosurgery, Hannover Nordstadt Hospital
  • J. Baldauf - Department of Neurosurgery, Ernst Moritz Arndt University, Greifswald
  • H. Schroeder - Department of Neurosurgery, Ernst Moritz Arndt University, Greifswald
  • M. Gaab - Department of Neurosurgery, Hannover Nordstadt Hospital

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. DocFR.12.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc081.shtml

Published: May 8, 2006

© 2006 Oertel 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.

Outline

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Objective: The optimal treatment of arachnoid cysts remains controversial. The authors employ since 1993 an endoscopic approach. Here the results with this approach are presented.

Methods: Between April 1993 and October 2005, 29 patients (2 males, 9 females, mean age 26 yrs [range 3 weeks – 74 yrs]) received 32 endoscopic operations for an arachnoid cyst. All patients were prospectively followed.

Results: Twenty-one cysts were located in the temporal lobe, 6 perisellar, and 2 in the foramen magnum. An endoscopic cystocisternostomy was performed in 23, a ventriculocystostomy in 4, a ventriculocystocisternostomy in 4, and no stomy in 1. The mean surgical time scored 86 min (range 35 - 150 min). The mean follow-up period was 16 months (range 1 week – 48 months). Complications consisted of 1 CSF fistula, 2 meningitides, 1 transient trochlear nerve palsy, 1 transient oculomotor nerve palsy, 1 permanent diabetes insipidus, and 1 epidural hematoma. Endoscopic revisions for stomy closure had to be performed in 3 cases. After surgery 24 patients became symptom free, 7 improved, and 1 remained unchanged. On MRI, the arachnoid cyst decreased in 21 and remained unchanged in 11. There was CSF flow through the stomy in 11 of 13 cases studied.

Conclusions: In all, the endoscopic approach can be considered safe and successful for arachnoid cyst treatment. However, a longer follow-up is required before definitive conclusions can be drawn.