NEW SURGICAL-TREATMENT OF MIDDLE FOSSA ARACHNOID CYST

BACKGROUND A new surgical treatment of middle fossa arachnoid cyst is reported. The benefit of our surgical procedure is to maintain the phy siologic pathway of the cerebrospinal fluid (CSF) without a shunting p rocedure. METHODS Following a small frontotemporal craniotomy, a linea r incision in the outer wall of the cyst is made. The basal subarachno id cisterns and distal sylvian cisterns are widely opened microsurgica lly. The outer wall of the cyst is then closed to prevent CSF leakage (arachnoidplasty). RESULTS We have experienced six patients who underw ent this new surgical treatment. All their cysts showed no or delayed influx of the contrast medium on preoperative computed tomography cist ernogram. A favorable outcome was attained in the long-term follow-up without any complications. CONCLUSIONS The present technique was desig ned to secure physiologic CSF circulation and to avoid the use of a sh unting system. A total of six patients treated with our new technique have been followed-up 6 years, and a good clinical outcome has been ob served in all of them without complications.