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Category: Volume 07 Issue 03 March 2019
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Title: Neuro Endoscopic Excision of Third Ventricular Colloid Cyst- Our Institutional Experience

Authors: Prof. M.M. Sankar.M.Ch., Pallavan. M.ch., S. Rajkumar. Mch., R.Saravana Santhosh Kumar.M.Ch.

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.198

Abstract

Objective: Colloid cyst of the third ventricle is a rare intracranial benign condition. Though micro neurosurgical technique is preferred for total resection, still subtotal resections and higher post operative morbidity like disconnection syndrome occur even with best surgical hands. Recently, Neuroendoscopy is emerging as an effective alternative to open craniotomy and microsurgical procedures. We present our neuroendoscopic technique for complete removal of third ventricular colloid cyst

Material and Methods: The study was carried out on 15 patients (Males-10, Females-5) spanning over a period of 4 years. The age group of the patients ranged from 16years-60 years. Depending on the radiological appearance, The procedure was performed with a right or left precoronal burr hole. We planned for complete excision of the entire cyst, including the cyst wall using the technique pioneered by our senior authors[4,5]. All patients were operated by precoronal uniportal transventricular technique using a rigid neuroendoscope of 2.7 mm in diameter, with an optical 30°.circumferential coagulation of the colloid wall, followed by a puncture aspiration of cystic contents and gross total resection of its wall by grasping and rotating the grasping forceps until the cyst wall separated from the attachment and removal of cyst with endoscope as a whole with the sheath.

Results: Complete excision was possible in 14 cases, In one patient a small part of the cyst was left to avoid venous injury. Two case of intra ventricular bleed needed External Ventricular Drainage (EVD). The operative time ranged between 50 minutes to 90 minutes. The inpatient stay time range from 5-10 days. The mean follow-up time was two years Pre operative signs and symptoms improved in all our patients without any mortality.

Conclusion: These results shows  that neuro endoscopy with our technique is a safe and effective alternative to the well established approaches of craniotomy with microsurgical excision and stereotactic aspiration with a short recovery time, hospital stay and low or negligible direct surgical morbidity.

Keywords: Neuroendoscopic Excision; Micro neurosurgery; Craniotomy; Colloid Cysts.

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Corresponding Author

Pallavan. M.ch.

Neuro surgery Post graduate, Dept of Neurosurgery, Government Stanley Medical College, Chennai, Tamilnadu, India