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J Neurol Surg A Cent Eur Neurosurg 2023; 84(03): 261-268
DOI: 10.1055/a-1712-5567
Original Article

Endoscopic Fenestration for Treating Galassi Type III Middle Cranial Fossa Arachnoid Cysts: Single- and Multiple-stoma have the Same Curative Effect

Guang-tong Zhu
1   Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China
,
Chu-zhong Li
1   Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China
,
Song-bai Gui
2   Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
,
Peng Zhao
2   Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
,
Zhen-ye Li
2   Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
,
Chun-hui Liu
2   Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
,
Ya-zhuo Zhang
1   Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China
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Abstract

Background For endoscopic fenestration of middle cranial fossa arachnoid cysts (MCFACs), the decisions on the location and number of stomas are key issues. However, research on this particular topic has been limited. Thus, this study aimed to compare single- versus multiple-stoma endoscopic fenestration for treating Galassi type III MCFACs.

Methods This retrospective study included 86 patients with Galassi type III MCFACs treated with endoscopic fenestration. Single-stoma fenestration to the basal cistern was performed in 37 cases, whereas multiple-stoma fenestration to the basal cistern and the carotid cistern was performed in 49 cases. Clinicoradiologic profiles and follow-up data were analyzed.

Results The rate of symptom relief was 83.7% (72/86), and the rate of cyst shrinkage was 96.5% (83/86). Postoperative ipsilateral subdural effusion, which was significant (p = 0.042), and noninfectious fever were the two most common complications in the single- and multiple-stoma groups. No significant differences in intraoperative nerve injury, vascular injury, proportion of cases with cyst reduction, and symptom remission rate were observed between the two groups. The rates of cyst recurrence and secondary surgery in the single-stoma group were higher than those in the multiple-stoma group, although the difference was not significant.

Conclusion Endoscopic fenestration is an effective and minimally invasive approach for treating Galassi type III MCFACs. Single- and multiple-stoma endoscopic fenestrations have the same curative effect.

Keywords

arachnoid cysts - middle cranial fossa - neuroendoscopy - stoma - subdural - effusion


Publication History

Received: 23 July 2021

Accepted: 30 November 2021

Accepted Manuscript online:
03 December 2021

Article published online:
30 June 2022

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