Microsurgical and endoscopic-assisted supraorbital keyhole approach for intra-suprasellar cysticercosis

Abstract

Background: Treatment for intra/suprasellar cysticercosis can be challenging and may result in visual disturbances if not managed properly. Despite its limited knowledge, an effective surgical option exists to treat this condition. This article presents three cases of sellar cysticercosis, comprising one female and two male patients, managed with microsurgical supraorbital keyhole approach (mSKA) and endoscopic-assisted supraorbital keyhole approach (eaSKA). Case Description: The first patient is a 35-year-old man with no prior medical history who suffered from memory deficits and visual disturbances due to a sellar cyst pushing the orbitofrontal gyrus treated with mSKA. The second case involved a 52-year-old man who experienced visual deficits caused by a rostral sellar cyst with posterior displacement of the pituitary gland treated with eaSKA. The third case was a 46-year-old woman who experienced decreased visual acuity and memory loss due to multifocal neurocysticercosis (NCC) with sellarsuprasellar cyst extension treated with mSKA. All case diagnoses were confirmed by neuropathology department. Conclusion: The authors confidently suggest that the SKA is an effective surgical option and could be considered for removing sellar cystic lesions with suprasellar extension. With endoscopic assistance, it improves adequate neurovascular structure visualization.

Current Role of Surgery in the Treatment of Neurocysticercosis

“…The inflammatory reactions that may be triggered upon anthelminthic treatment can either initiate or deteriorate the previous compressive effect. For cranial nerves, there have been reported cases of visual loss, trigeminal pain, and facial nerve dysfunctions secondary to the compressive effects of cisternal cysts [ 55 , 56 , 57 , 58 ]. Cysts in the subarachnoid space of the spine can compress the spinal roots and the spinal cord.…”