Endoscopic Colloid Cyst Resection: Technical Note

Boogaarts, Hieronymus D.; Elkheshin, Sherif; Grotenhuis, J.A.

doi:10.1055/s-0031-1275734

Cited by 12 publications

(9 citation statements)

References 3 publications

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“…5,6,9,13,14,16,17,20,27,28,34 Although each treatment modality has shown fairly good clinical outcome, there has been discussion about which approach is the procedure of choice, especially between transcallosal or transcortical and endoscopic excision. In comparison with the traditional transcallosal-transventricular or transcortical-transventricular approach and cyst aspiration with stereotactic guidance, the role of neuroendoscopy in removal of colloid cysts only started recently.…”

Section: Discussionmentioning

confidence: 99%

“…Lewis et al, 20 King et al, 18 Levine et al, 19 and Boogaarts et al 5 chose the entry point at 1 cm anterior to the coronal suture and 4-5 cm from the sagittal suture. Longatti et al, 22 Rodziewicz et al, 26 and Mishra et al 23 selected an entry point 1-4 cm anterior to the coronal suture and 2-5 cm relative to the midline.…”

Section: Discussionmentioning

confidence: 99%

“…8,12,24 There are different surgical treatments, including microsurgical resection, endoscopic resection, stereotactic aspiration, and ventriculoperitoneal shunt im plan tation. 5,6,9,10,13,[15][16][17]20,23,[26][27][28][29][30]34 Nowadays, the most popular approaches are microsurgical and endoscopic resection. Transcortical or transcallosal are the two microsurgical approaches for colloid cyst resection.…”

mentioning

confidence: 99%

“…With recently improved neuroendoscopic techniques, the number of cases with endoscopic excision is rising. 5,6,9,10,23,29,34 As part of the endoscopic procedure, selection of an entry point is crucial. The location of the entry point determines the trajectory the endoscope follows.…”

mentioning

confidence: 99%

“…5,6,9,14,16 Gross-total resection can also probably be achieved by carefully choosing an optimal trajectory. However, the selection of the trajectory to the colloid cyst differs a great deal in the literature.…”

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confidence: 99%

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Endoscopic approach to colloid cyst: what is the optimal entry point and trajectory?

Rangel-Castilla

Chen

Choi

et al. 2014

JNS

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Object. An optimal entry point and trajectory for endoscopic colloid cyst (ECC) resection helps to protect important neurovascular structures. There is a large discrepancy in the entry point and trajectory in the neuroendoscopic literature.Methods. Trajectory views from MRI or CT scans used for cranial image guidance in 39 patients who had undergone ECC resection between July 2004 and July 2010 were retrospectively evaluated. A target point of the colloid cyst was extended out to the scalp through a trajectory carefully observed in a 3D model to ensure that important anatomical structures were not violated. The relation of the entry point to the midline and coronal sutures was established. Entry point and trajectory were correlated with the ventricular size.Results. The optimal entry point was situated 42.3 ± 11.7 mm away from the sagittal suture, ranging from 19.1 to 66.9 mm (median 41.4 mm) and 46.9 ± 5.7 mm anterior to the coronal suture, ranging from 36.4 to 60.5 mm (median 45.9 mm). The distance from the entry point to the target on the colloid cyst varied from 56.5 to 78.0 mm, with a mean value of 67.9 ± 4.8 mm (median 68.5 mm). Approximately 90% of the optimal entry points are located 40-60 mm in front of the coronal suture, whereas their perpendicular distance from the midline ranges from 19.1 to 66.9 mm. The location of the "ideal" entry points changes laterally from the midline as the ventricles change in size.Conclusions. The results suggest that the optimal entry for ECC excision be located at 42.3 ± 11.7 mm perpendicular to the midline, and 46.9 ± 5.7 mm anterior to the coronal suture, but also that this point differs with the size of the ventricles. Intraoperative stereotactic navigation should be considered for all ECC procedures whenever it is available. The entry point should be estimated from the patient's own preoperative imaging studies if intraoperative neuronavigation is not available. An estimated entry point of 4 cm perpendicular to the midline and 4.5 cm anterior to the coronal suture is an acceptable alternative that can be used in patients with ventriculomegaly.

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