1. Fully endoscopic endonasal approach for the treatment of intrasellar arachnoid cysts
- Author
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Thierry Brue, Stéphane Fuentes, Henry Dufour, Sébastien Boissonneau, Vincent Amodru, Jean d’Artigues, Kaissar Farah, Thomas Graillon, Hôpital de la Timone [CHU - APHM] (TIMONE), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Marseille Maladies Rares (MarMaRa), Aix Marseille Université (AMU), Département de Neurochirurgie [CHU Timone], and Service d'endocrinologie, diabète, maladies métaboliques [Hôpital de la Conception - APHM]
- Subjects
[SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT] ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Endonasal approach ,Endocrinology ,Arachnoid cysts ,Arachnoid cyst ,medicine ,Humans ,Cyst ,ComputingMilieux_MISCELLANEOUS ,Craniotomy ,Retrospective Studies ,Cerebrospinal Fluid Leak ,business.industry ,Endoscopy ,medicine.disease ,Endoscopic surgery ,Surgery ,Skull base ,Treatment Outcome ,Diabetes insipidus ,Syndrome of inappropriate antidiuretic hormone secretion ,Intrasellar cyst ,Headaches ,medicine.symptom ,business ,Complication ,Meningitis ,Diabetes Insipidus ,Cyst obliteration - Abstract
International audience; PurposeTo report our experience of endoscopic endonasal obliteration of symptomatic sellar arachnoid cyst (SAC).MethodsFrom 2002 to 2019, we retrospectively reported the data of 17 cases of SAC operated in Timone University Hospital, Marseille, France. Preoperative clinical findings were collected including main symptoms, visual function and endocrinological assessment. Surgical procedure was homogeneous and consisted in endonasal fully endoscopic surgical obliteration of the cyst cavity with fat graft. Post-operative outcomes, complication and follow-up was reported.ResultsVisual disorders and/or headaches were the main symptoms. Our technique provided improvement for 83.3% of the patients suffering from visual disturbance and for 87.5% of those suffering from headaches. We reported 2 cases of cerebrospinal fluid (CSF) leakage (11.8%), but no meningitis. One case of definitive diabetes insipidus occurred and one case of postoperative syndrome of inappropriate antidiuretic hormone secretion was temporary. There was one case of recurrence reported. The mean follow-up was 39 months.ConclusionPatients with symptomatic SAC can be treated successfully by endoscopic endonasal obliteration of the cyst. This simple technique offers true benefits for the patients without craniotomy, but the complication rate remains high especially with the risk of CSF leakage. Special attention to skull base opening and closing could reduce this risk.
- Published
- 2021
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