J Neurol Surg A Cent Eur Neurosurg 2014; 75(05): 376-380
DOI: 10.1055/s-0033-1343984
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Management of Colloid Cysts

Yad Ram Yadav
1   Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, Madhya Pradesh, India
,
Vijay Parihar
1   Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, Madhya Pradesh, India
,
Sonjjay Pande
2   Department of Radiodiagnosis, NSCB Medical College Jabalpur, Madhya Pradesh, India
,
Hemant Namdev
1   Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, Madhya Pradesh, India
› Author Affiliations
Further Information

Publication History

20 February 2012

01 February 2013

Publication Date:
22 May 2013 (online)

Abstract

Background Microsurgical resection, stereotactic aspiration, endoscopically assisted microsurgical resection, and ventriculoperitoneal shunt have been the treatment options for colloid cysts of the third ventricle. Recently, an endoscopic approach has been recognized as an effective alternative to open surgery. There is suspicion about the long-term recurrence rate and about obtaining complete removal of cyst.

Patients and Methods This is a prospective study of 24 patients with colloid cyst who underwent endoscopic resection. Preoperative computed tomography (CT) scans revealed hydrocephalus in all the patients. Postoperative magnetic resonance imaging (MRI) was done in all cases.

Results Age ranged from 16 to 57 years. There were 16 male and 8 female patients. The diameter of the cyst varied from 14 to 24 mm. Operating time ranged from 90 to 156 minutes. Total resection was achieved in 21 patients. All patients with subtotal excision underwent coagulation of residual cyst wall. The follow-up period ranged from 6 to 78 months (mean, 37 months). None of the patients developed any symptoms at 26, 31, and 39 months of follow-up. Preoperative symptoms disappeared in all the patients except for memory disorders and seizures in one patient each. No residual cyst was observed on the postoperative MRIs in 21 patients. Hospital stay was 4 to 10 days (median, 6 days). No endoscopic operation was converted into an open resection.

Conclusion Endoscopic excision of a colloid cyst is an effective and safe alternate method. Although the follow-up time was short, residual cyst wall remained asymptomatic without any evidence of growth after subtotal excision and coagulation of wall.

 
  • References

  • 1 Yadav YR, Parihar V, Agarwal M, Sherekar S, Bhatele P. Endoscopic vascular decompression of the trigeminal nerve. Minim Invasive Neurosurg 2011; 54 (3) 110-114
  • 2 Rodziewicz GS, Smith MV, Hodge Jr CJ. Endoscopic colloid cyst surgery. Neurosurgery 2000; 46 (3) 655-660 , discussion 660–662
  • 3 Yadav YR, Parihar V, Namdev H, Agarwal M, Bhatele PR. Endoscopic interlaminar management of lumbar disc disease. J Neurol Surg A 2013; 74: 77-81
  • 4 Yadav YR, Shenoy R, Mukerji G, Parihar V. Water jet dissection technique for endoscopic third ventriculostomy minimises the risk of bleeding and neurological complications in obstructive hydrocephalus with a thick and opaque third ventricle floor. Minim Invasive Neurosurg 2010; 53 (4) 155-158
  • 5 Charalampaki P, Filippi R, Welschehold S, Perneczky A. Endoscope-assisted removal of colloid cysts of the third ventricle. Neurosurg Rev 2006; 29 (1) 72-79
  • 6 Abdou MS, Cohen AR. Endoscopic treatment of colloid cysts of the third ventricle. Technical note and review of the literature. J Neurosurg 1998; 89 (6) 1062-1068
  • 7 Schroeder HW, Gaab MR. Endoscopic resection of colloid cysts. Neurosurgery 2002; 51 (6) 1441-1444 , discussion 1444–1445
  • 8 Hellwig D, Bauer BL, Schulte M, Gatscher S, Riegel T, Bertalanffy H. Neuroendoscopic treatment for colloid cysts of the third ventricle: the experience of a decade. Neurosurgery 2008; 62 (6) (Suppl. 03) 1101-1109
  • 9 Maqsood AA, Devi IB, Mohanty A, Chandramouli BA, Sastry KV. Third ventricular colloid cysts in children. Pediatr Neurosurg 2006; 42 (3) 147-150
  • 10 Deinsberger W, Böker DK, Samii M. Flexible endoscopes in treatment of colloid cysts of the third ventricle. Minim Invasive Neurosurg 1994; 37 (1) 12-16
  • 11 Mishra S, Chandra PS, Suri A, Rajender K, Sharma BS, Mahapatra AK. Endoscopic management of third ventricular colloid cysts: eight years' institutional experience and description of a new technique. Neurol India 2010; 58 (3) 412-417
  • 12 Horváth Z, Vetö F, Balás I, Dóczi T. Complete removal of colloid cyst via CT-guided stereotactic biportal neuroendoscopy. Acta Neurochir (Wien) 2000; 142 (5) 539-545 , discussion 545–546
  • 13 Vialogo JG. [Endoscopic transepto-interforniceal approach to colloid cysts: case report]. Arq Neuropsiquiatr 2000; 58 (3B) 939-946
  • 14 Grondin RT, Hader W, MacRae ME, Hamilton MG. Endoscopic versus microsurgical resection of third ventricle colloid cysts. Can J Neurol Sci 2007; 34 (2) 197-207
  • 15 Decq P, Le Guerinel C, Brugières P , et al. Endoscopic management of colloid cysts. Neurosurgery 1998; 42 (6) 1288-1294 , discussion 1294–1296
  • 16 Longatti P, Martinuzzi A, Moro M, Fiorindi A, Carteri A. Endoscopic treatment of colloid cysts of the third ventricle: 9 consecutive cases. Minim Invasive Neurosurg 2000; 43 (3) 118-123
  • 17 Acerbi F, Rampini P, Egidi M, Locatelli M, Borsa S, Gaini SM. Endoscopic treatment of colloid cysts of the third ventricle: long-term results in a series of 6 consecutive cases. J Neurosurg Sci 2007; 51 (2) 53-60
  • 18 Horn EM, Feiz-Erfan I, Bristol RE , et al. Treatment options for third ventricular colloid cysts: comparison of open microsurgical versus endoscopic resection. Neurosurgery 2007; 60 (4) 613-618 , discussion 618–620
  • 19 Greenlee JD, Teo C, Ghahreman A, Kwok B. Purely endoscopic resection of colloid cysts. Neurosurgery 2008; 62 (3) (Suppl. 01) 51-55 , discussion 55–56
  • 20 King WA, Ullman JS, Frazee JG, Post KD, Bergsneider M. Endoscopic resection of colloid cysts: surgical considerations using the rigid endoscope. Neurosurgery 1999; 44 (5) 1103-1109 , discussion 1109–1111
  • 21 Engh JA, Lunsford LD, Amin DV , et al. Stereotactically guided endoscopic port surgery for intraventricular tumor and colloid cyst resection. Neurosurgery 2010; 67 (3, Suppl Operative): ons198-ons204 , discussion ons204–ons205
  • 22 Boogaarts H, El-Kheshin S, Grotenhuis J. Endoscopic colloid cyst resection: technical note. Minim Invasive Neurosurg 2011; 54 (2) 95-97
  • 23 Boogaarts HD, Decq P, Grotenhuis JA , et al. Long-term results of the neuroendoscopic management of colloid cysts of the third ventricle: a series of 90 cases. Neurosurgery 2011; 68 (1) 179-187
  • 24 Kehler U, Brunori A, Gliemroth J , et al. Twenty colloid cysts—comparison of endoscopic and microsurgical management. Minim Invasive Neurosurg 2001; 44 (3) 121-127
  • 25 Longatti P, Godano U, Gangemi M , et al; Italian neuroendoscopy group. Cooperative study by the Italian neuroendoscopy group on the treatment of 61 colloid cysts. Childs Nerv Syst 2006; 22 (10) 1263-1267
  • 26 Levine NB, Miller MN, Crone KR. Endoscopic resection of colloid cysts: indications, technique, and results during a 13-year period. Minim Invasive Neurosurg 2007; 50 (6) 313-317
  • 27 Gurjar H, Dwarakanath S, Sharma BS, Chandra S. Cerebellar hemorrhage following endoscopic third ventricular colloid cyst decompression. Neurol India 2008; 56 (2) 218-220
  • 28 Boogaarts H, Grotenhuis A. Terson's syndrome after endoscopic colloid cyst removal: case report and a review of reported complications. Minim Invasive Neurosurg 2008; 51 (5) 303-305
  • 29 Stachura K, Libionka W, Moskała M, Krupa M, Polak J. Colloid cysts of the third ventricle. Endoscopic and open microsurgical management. Neurol Neurochir Pol 2009; 43 (3) 251-257
  • 30 Schroeder HW, Oertel J, Gaab MR. Incidence of complications in neuroendoscopic surgery. Childs Nerv Syst 2004; 20 (11-12) 878-883