scholarly journals ENDOSCOPIC TREATMENT OF ARACHNOID CYSTS OF THE MIDDLE CRANIAL FOSSA IN CHILDREN

2020 ◽  
pp. 390-397
Author(s):  
R.A. SUFIANOV ◽  
◽  
M.M. ABDUMAZHITOVA ◽  
R.R. RUSTAMOV ◽  
A.A. SUFIANOV ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Middle Cranial Fossa ◽  
Speech Development ◽  
Arachnoid Cysts ◽  
Total Efficiency ◽  
Symptomatic Epilepsy ◽  
Cranial Fossa ◽  
The Right ◽  
Observation Period

Objective: Improvement of the results and effectiveness of endoscopic treatment for arachnoid cysts of the middle cranial fossa (AC MCF) in children. Methods: At the Federal Center for Neurosurgery of Tyumen 65 patients with AC MCF were operated from 2012 to 2018 by endoscopic cystocisternostomy (ECCS). Patients age ranged from one month up to 17 years. Children under 3 years old were – 32 (49%). Hypertensive symptoms were in 26 (40%); delayed speech development in 20 (31%); symptomatic epilepsy in 12 (18.5%); pathology of the ocular fundus was in 5 (7.7%). Associated abnormalities were in 19 (29%). All patients underwent CT and/or MRI. In 46 (71%) patients, cysts were located on the right, in 13 (20%) on the left and 6 (9%) bilateral. The displacement of the middle structures was diagnosed in 45 (69%). According to the Galassi classification: type II was in 20 (31%), type III – in 45 (69%) patients. The average volume of AC MCF before the operation was 181±18.6 cm3. All 65 patients underwent ECCS: a miniature neuroendoscope KarlStorz – Endoskop 11576 KF/KG was used in 47 patients, and a standard rigid endoscope LOTTA, «Gaab I scope» or flexible video scope was used in 18 patients. Results: The postoperative observation period ranged from 1 year to 8 years. The volume of cysts after surgery averaged 124.8±17.2 cm3. On average, the volume of cysts decreased by 58.2±13.5 cm3. The total efficiency of ECCS in 65 patients with AC MCF reached 81.5% of cases. Relapse was noted in 14 patients (22%). The period of recurrence ranged from 1 month to 81 month. Recurrence was in 71% of children under the age of 3 years. There was a correlation between repeated interventions and age. Children under 3 years of age have the efficiency of surgical treatment at 68.8% than in children over 3 years old – 93.8% (p≤0.01). The results of surgical treatment, depending on the endoscope used, were statistically unreliable, because when using Karl Storz – Endoskop 11576 KF/KG the total efficiency was 81%, and when using LOTTA, «Gaab I scope» or a flexible video scope – 84%. Complications in the postoperative period occurred in 6 (9%) children. Conclusions: The effectiveness of ECCS in 65 children with AC MCF reached 81.5% of cases. The effectiveness of ECCS in children under 3 years of age was 68.7%, and 93.7% in children older than 3 years. Keywords: Middle cranial fossa , arachnoid cysts in children, intracranial cyst, endoscopic treatment, endoscopic cystocisternostomy.

Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children

2000 ◽  
Vol 16 (2) ◽  
pp. 111-116 ◽  
Author(s):  
J. -K. Kang ◽  
K. S. Lee ◽  
I. W. Lee ◽  
S. S. Jeun ◽  
B. C. Son ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Cranial Fossa

Assessment of endoscopic treatment for middle cranial fossa arachnoid cysts

2011 ◽  
Vol 27 (7) ◽  
pp. 1121-1128 ◽  
Author(s):  
Song-bai Gui ◽  
Xin-sheng Wang ◽  
Xu-yi Zong ◽  
Chu-zhong Li ◽  
Bo Li ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Cranial Fossa

scholarly journals Atypical clinical course of cerebral arachnoid cyst

2015 ◽  
Vol 17 (2) ◽  
pp. 77
Author(s):  
A. L. Krivoshapkin ◽  
A. V. Gorbatykh ◽  
A. S. Gaytan ◽  
P. A. Semin ◽  
V. V. Kobozev
Keyword(s):  
Surgical Treatment ◽  
Intracranial Pressure ◽  
Female Patient ◽  
Arachnoid Cyst ◽  
Clinical Course ◽  
Operative Management ◽  
Middle Cranial Fossa ◽  
Raised Intracranial Pressure ◽  
Cranial Fossa ◽  
Aggressive Clinical Course

In this publication we report a case of atypical, aggressive clinical course of arachnoid cyst in 19-year old female patient, which caused raised intracranial pressure and disruption of bony structures of the middle cranial fossa and the orbit. It also describes peculiarities of operative management and results of surgical treatment of this patient.

Endoscopic fenestration for treating Galassi type III middle cranial fossa arachnoid cysts: single- and multiple-stoma have the same curative effect

2021 ◽  
Author(s):  
Guangtong Zhu ◽  
Chuzhong Li ◽  
Songbai Gui ◽  
Peng Zhao ◽  
Zhenye Li ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Subdural Effusion ◽  
Basal Cistern ◽  
Curative Effect ◽  
Invasive Approach ◽  
Type Iii ◽  
Cranial Fossa ◽  
Endoscopic Fenestration

Background and Study Aims For endoscopic fenestration of middle cranial fossa arachnoid cysts (MCFACs), the decisions on the location and number of stomas are key issues in the operation. However, research on this particular topic has been limited. Thus, this study aimed to compare single-stoma versus multiple-stoma endoscopic fenestration for treating Galassi type III MCFACs. Patients and Methods This retrospective study included 86 patients with Galassi type III MCFACs treated with endoscopic fenestration. Single-stoma fenestration to the basal cistern was performed in 37 cases, while multiple-stoma fenestration to the basal cistern and the carotid cistern was performed in 49 cases. Clinico-radiological profiles and follow-up data were analyzed. Results The rate of symptom relief was 83.7%(72/86), and the rate of cyst shrinkage was 96.5%(83/86). Postoperative ipsilateral subdural effusion, which was significant(P=0.042), and non-infectious fever were the two most common complications in the single-stoma and multiple-stoma groups. No significant differences in intraoperative nerve injury, vascular injury, proportion of cases with cyst reduction, and symptom remission rate were observed between both groups. The rates of cyst recurrence and secondary surgery in the single-stoma group were higher than those in the multiple-stoma group, although the difference was not significant. Conclusion Endoscopic fenestration is an effective and minimally invasive approach for treating Galassi type III MCFACs. Single-stoma and multiple-stoma have the same curative effect.

Arachnoid cysts

2019 ◽  
pp. 1101-1106
Author(s):  
Ruichong Ma ◽  
Stana Bojanic
Keyword(s):  
Cerebral Spinal Fluid ◽  
Spinal Column ◽  
Middle Cranial Fossa ◽  
Paediatric Population ◽  
Arachnoid Cysts ◽  
Arachnoid Membrane ◽  
Head Growth ◽  
Asymptomatic Patients ◽  
Cranial Fossa ◽  
Endoscopic Fenestration

First described in 1831, arachnoid cysts are cerebral spinal fluid-filled spaces lined with arachnoid membrane. They account for 1% of all intracranial space occupying lesions and can also be found rarely in the spinal column. Most intracranial arachnoid cysts are found in the middle cranial fossa with a male predilection and a slight preponderance for the left side. With the availability of modern imaging, many more arachnoid cysts are being picked up incidentally in asymptomatic patients. However, symptomatic arachnoid cysts are predominantly found in the paediatric population with patients typically presenting with headaches, rapid head growth, developmental delay, and seizures. Treatment of patients with asymptomatic arachnoid cysts has typically been conservative management with surgery only considered in patients with symptoms. Surgical management remains controversial and includes open techniques, endoscopic fenestration of cyst, or shunting procedures.

Location of the middle cranial fossa dural plate in patients with chronic otitis media

2014 ◽  
Vol 128 (1) ◽  
pp. 60-63 ◽  
Author(s):  
S Genc ◽  
M G Genc ◽  
I B Arslan ◽  
A Selcuk
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Middle Cranial Fossa ◽  
Control Group ◽  
Adjacent Structures ◽  
Cranial Fossa ◽  
The Mean ◽  
Bone Scans ◽  
The Right ◽  
And Control

AbstractAim:This study aimed to determine whether or not the middle cranial fossa dural plate is located lower (i.e. more caudally) in patients with chronic otitis media, relative to adjacent structures.Methods:The authors retrospectively investigated computed tomography temporal bone scans of 267 ears of 206 patients who had undergone surgery with a diagnosis of chronic otitis media, together with scans of 222 ears of 111 patients without chronic otitis media. The depth of the middle cranial fossa dural plates was recorded.Results:The mean depth of the middle cranial fossa dural plate was 4.59 mm in the study group and 2.71 mm in the control group (p < 0.001). The middle cranial fossa dural plate was located lower in the right ear in both the study and control groups.Conclusion:The middle cranial fossa dural plate was located lower in patients with chronic otitis media, and in the right ears of both patients and controls. Surgeons should take this low location into consideration, and take extra care, during relevant surgery on patients with chronic otitis media.

CT SCAN AND METRIZAMIDE CT CISTERNOGRAPHY IN ARACHNOID CYSTS OF THE MIDDLE CRANIAL FOSSA

1982 ◽  
Vol 6 (6) ◽  
pp. 1226
Author(s):  
E. Galassi ◽  
E. Tognetti ◽  
G. Gaist ◽  
L. Fagioli ◽  
F. Frank ◽  
...  
Keyword(s):  
Ct Scan ◽  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Ct Cisternography ◽  
Cranial Fossa ◽  
Metrizamide Ct Cisternography

Arachnoid cysts of the middle cranial fossa: a consideration of their origins based on imaging

1993 ◽  
Vol 35 (5) ◽  
pp. 355-358 ◽  
Author(s):  
J. M. Garc�a Santos ◽  
J. Mart�nez-Lage ◽  
A. Gilabert Ubeda ◽  
A. Capel Alem�n ◽  
V. Climent Oltr�
Keyword(s):  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Cranial Fossa

Intracranial arachnoid cysts in children. A comparison of the effects of fenestration and shunting

1991 ◽  
Vol 74 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Samuel F. Ciricillo ◽  
Philip H. Cogen ◽  
Griffith R. Harsh ◽  
Michael S. B. Edwards
Keyword(s):  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Shunt Revision ◽  
Content Type ◽  
Cyst Recurrence ◽  
Cranial Fossa ◽  
The Subject ◽  
Low Incidence ◽  
Cyst Fenestration

✓ The best operative intervention for children with arachnoid cysts remains the subject of controversy. Recent reports stress that craniotomy for cyst fenestration is associated with a low incidence of morbidity and mortality and may leave the child shunt-independent. The cases of 40 pediatric patients with arachnoid cysts treated between 1978 and 1989 are reported. Five children with mild symptoms and small cysts that remained stable on follow-up studies have not required surgical intervention. Of 15 patients with cysts initially treated by fenestration, 10 (67%) showed no clinical or radiographic improvement postoperatively and have undergone cyst-peritoneal (eight patients) or ventriculoperitoneal (VP) shunting (one patient), or revision of a VP shunt placed for hydrocephalus before cyst fenestration (one patient). Two other patients with existing VP shunts required no further procedures. Thus, only three (20%) of 15 patients initially treated by fenestration remain shunt-independent after a median follow-up period of 8 years. The 20 other patients were initially treated by cyst shunting and all improved postoperatively; shunt revision has been necessary in six (30%) of these 20 patients because of cyst recurrence, Cyst location influenced the success of shunt treatment; none of the seven middle cranial fossa cysts treated by shunting have required revision, but results with cysts in other locations were less favorable. In all locations, though, shunting was more successful than fenestration. It is concluded that cyst-peritoneal or cyst-VP shunting is the procedure of choice for arachnoid cysts in most locations, including those in the middle cranial fossa.

Endoscopic treatment of quadrigeminal arachnoid cysts in children

2013 ◽  
Vol 12 (5) ◽  
pp. 521-528 ◽  
Author(s):  
Nasser M. F. El-Ghandour
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Endoscopic Procedure ◽  
Arachnoid Cysts ◽  
Third Ventriculostomy ◽  
Cyst Size ◽  
Shunt Placement ◽  
Postoperative Mri ◽  
Quadrigeminal Cistern ◽  
First Choice

Object Quadrigeminal arachnoid cysts (QACs) are rare, comprising approximately 5%–10% of all intracranial arachnoid cysts. The management of these cysts is challenging, and their optimal surgical treatment is controversial. This study evaluates the role of endoscopy in the treatment of QACs in children, focusing on some factors or technical aspects that might influence the outcome. Methods Eighteen children with symptomatic QACs were the subject of this study. The group included 10 boys and 8 girls, with a mean age of 2.5 years. All patients had hydrocephalus. Surgical treatment included ventriculocystostomy (14 cases), endoscopic third ventriculostomy (14 cases), ventriculocystocisternostomy (2 cases), cystocisternostomy (2 cases), and removal of preexisting malfunctioning cystoperitoneal shunt (4 cases). Results Significant clinical improvement occurred in 15 cases (83.3%). Postoperative MRI showed a reduction in the cyst size in 14 cases (77.8%), whereas in the remaining 4 cases (22.2%) the cyst size was unchanged. A postoperative decrease in ventricular size was encountered in 16 cases (88.9%). Minor intraoperative bleeding occurred in 1 case (5.6%), which stopped spontaneously without any postoperative sequelae. Postoperative subdural hygroma occurred in 3 cases (16.7%) and required a subduroperitoneal shunt in 2 cases. During follow-up (mean 45.8 months), a repeat endoscopic procedure was performed in 7 patients (all 4 patients with a prior shunt and 3 patients without a prior shunt), and new shunt placement was required in 5 patients (all 4 patients with a prior shunt and 1 patient without a prior shunt). Thus, none of the patients with a prior shunt was able to become shunt independent, whereas 92.9% of patients without a prior shunt were able to avoid shunt placement. Conclusions Arachnoid cysts of the quadrigeminal cistern and the associated hydrocephalus can be effectively treated by endoscopy. The procedure is simple, minimally invasive, and associated with low morbidity and mortality rates. The fact that all patients who previously received shunts required a repeat endoscopic procedure and that none of these patients was able to become shunt independent makes it clear that endoscopic treatment should be considered the first choice in the management of patients with arachnoid cysts in the quadrigeminal cistern.

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