Endoscopic colloid cyst surgery

OBJECTIVE: The purpose of this report is to discuss the technical aspects o f operating on colloid cysts through a transventricular approach, with rigi d endoscopes. METHODS: Twelve patients underwent 14 endoscopic operations in attempts to treat their colloid cysts. All patients were symptomatic, with headache bei ng the most common complaint (8 of 12 patients). Six patients in this serie s exhibited enlarged ventricles associated with their colloid cysts. Using rigid endoscopes of less than or equal to 3.5-mm diameter, the cysts were i nspected and fenestrated. Both hard and soft cyst contents were evacuated, and then the walls of the cysts were coagulated inside and outside. Externa l ventriculostomy tubes were usually placed. Technical obstacles to success ful completion of endoscopic colloid cyst surgery are discussed. RESULTS: For 11 of the 12 patients, the colloid cysts could be treated via an endoscopic approach. The mean follow-up time was 173 weeks, and the medi an follow-up time was 125 weeks. For the 12th patient, bilateral scarring o f the foramina of Monro precluded direct surgery; therefore, a septostomy w as performed and a ventriculoperitoneal shunt was placed. CONCLUSION: Endoscopic transventricular surgery should be considered for th e treatment of colloid cysts.