Outcome of Endoscopic Excision of the Third Ventricular Colloid Cyst

Document Type : Original Article

Authors

1 Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

2 Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Colloid cyst of the third ventricle is not uncommon. The complete excision is crucial to relieve symptoms and prevent associated completions. Previously open excision was the role. However, the endoscopic approaches gained wide acceptance.
The aim of the work: The study aimed to assess the outcome of endoscopic excision of the third ventricular colloid cyst by symptoms resolution, excision extent and complications rate.
Patients and Methods: This is a retrospective study that covered the duration from February 2018 to February 2021. It included 20 subjects with a third ventricular colloid cyst, who managed by an endoscopic excision. Files were reviewed for preoperative evaluation [history, clinical neurological and ophthalmological examination] and radiological investigations to identify the cyst size, site, density and enhancement and the size of the third ventricle. Postoperatively, all patients were evaluated by general and neurological clinical examination, follow up imaging study immediately [second postoperative day], at 3 and 6 postoperative months. All complications and recurrence rate were documented, and results were graded on Barrow Neurological Institute scale.
Results: Males represented 60.0%; the mean age was 37.5±11.3 years. All had headache, 80.0% had blurred vision, and papilledema was recognized among 90.0%. The average size of the cyst was 17.4±2.66 mm. The total cyst removal was achieved for 85.0% and partial removal for 15.0%. Postoperative infections were developed in 20.0%. Three patients [15%] had temporary amnesia and one patient [5%] had intraventricular hemorrhage. All symptoms were resolved after surgery, except for three patients. Two of them [10%] had mild visual disturbance and one had amnesia. The recurrence of the cyst was detected in 2 patients [10%].
Conclusion: Endoscopic colloid cyst excision is an effective, safe and reliable technique with established learning curve. 

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