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Endoscopic surgery for colloid cysts: clinical and radiological outcome
EANS Academy. Molina Jaque F. Sep 27, 2019; 276093; EP04121
Felipe Molina Jaque
Felipe Molina Jaque

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Abstract
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Objective: Colloid cysts of the third ventricle may be treated in a variety of ways. We have reviewed the clinical and radiological outcome of endoscopic third ventriculostomy at our institution.
Design: Retrospective review of patients undergoin endoscopic reduction or removal of their cysts, between 1997 and 2019.
Subjects: 26 patients, 19 males and 7 females, mean age of 44 years, range 24 to 70. The follow-up interval varied from 6 to 72 months.
Outcome measures: Radiological outcome: size of cyst and ventricles. Clinical outcome: symptom progression. Failure was defined as the need for a further surgical procedure.
Results: All 26 patients had pellucidotomy as a preliminary manoeuvre and two had third ventriculostomy as a supplementary manoeuvre. Two patients had previously undergone insertion of bilateral ventriculo-peritoneal shunts. Six patients underwent aspiration of their cyst, eight had thermal reduction of the lesion and rongeur extraction of the tumour was done in 12 cases. Postoperative MR confirmed total removal of the cyst in 10 of the 26 cases. Volume reduction in another 14 cases and two patients showed no change in cyst size. Ventricular size was reduced in 22 out of 26 patients, unchanged in 2 cases and increased in 2 patients. Presenting symptoms resolved in 18 of the total group of 26 patients, improved in seven and remained unchanged in one patient.
Conclusions: Endoscopic surgery for colloid cysts is a useful treatment as defined by total removal of the cyst or reduction in ventricular size. We achieved total removal of the cyst in over a third of our cases.SYmptom improvements was observed in 25/26 patients. Ventriculoscopy is a minimally invasive way of treating these lesions, and it does not preclude the subsequent use of open craniotomy or CSF diversion, if the primary procedure fails to control the symptoms.
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