EVALUATION OF ENDOSCOPY IN THE TREATMENT OF RARE MENINGOCELES - PRELIMINARY-RESULTS

BACKGROUND Endoscopy is used on different occasions-for instance, to o pen the floor of the third ventricule in triventricular hydrocephalus, to open a cyst into the cerebrospinal fluid circulation, for biopsy o r for partial resection of some tumors, or to insert a shunt in hydroc ephalus or syringohydromyelia. However, the use of endoscopes for eval uating and treating meningoceles remains to be assessed. METHODS Five different kinds of rare meningoceles are presented. In each, neuroendo scopy was used as the main tool for exploration and treatment. RESULTS Two sacral meningoceles and one oral cephalocele were cured through a keyhole opening under endoscopic control. One posterior sacral mening ocele was explored and no communication with normal subarachnoid space s was observed, allowing a simple suture of the posterior to the anter ior walls. And, last, a complex case with three intrasacral meningocel es was explored and partially treated. CONCLUSIONS Meningoceles with v ery small communication within the normal subarachnoid spaces appeared the most suitable to be cured by an endoscopic procedure. In case of a larger communication, the meningocele could be treated, or at least the morphology can be better understood, by using a keyhole procedure under endoscopic control. In all cases the surgery was of short durati on (less than 1 hour) and very well tolerated.