Endoscopic management of third ventricular colloid cysts: Eight years′ institutional experience and description of a new technique

Abstract

Background : The operative approaches for colloid cyst excision are varied with open microsurgical excision still being considered as the "gold standard". Endoscopic removal of these cysts is gaining in popularity. Aims : To document the efficacy and safety of the endoscope for colloid cyst excision. Materials and Methods : Retrospective study of all the patients who underwent endoscopic colloid cyst excision between January 2000 and March 2009. Patient records, radiological images and operative notes were assessed. Follow-up data including clinical and radiological details were retrieved. Results : Fifty-nine cases underwent endoscopic surgery during the study period. Gross total excision of cyst (with small residual nubbin) could be achieved in 46 (78%) patients. Others patients underwent: near-total excision (seven); partial excision (five); and cyst aspiration (one). A two-port technique for achieving excision was used in 18 patients. There was one death due to fulminant meningitis. No patients had recurrence, follow-up till 99 months. Two patients required ventriculo peritonealshunt for persistent hydrocephalus. Conclusions : Endoscopic excision is a safe and effective, minimally invasive method for colloid cyst removal. Even a subtotal excision of these slow-growing cysts may be acceptable when experience with the endoscope is limited.