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Endoscopic trans-septal interforniceal approach for excision of colloid cysts of the third ventricle using the rotational technique

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Abstract

Colloid cysts of the third ventricle are benign intracranial lesions that account for 0.5 to 2% of all brain tumors and are even rarer in pediatric population. Dandy was the first to successfully excise a colloid cyst of the third ventricle via a transcortical transventricular approach in 1921. For several decades to follow, the transcortical transventricular and transcallosal microsurgical approaches remained the cornerstone of surgical management of these lesions. With time and refinements in endoscopic equipment and techniques, endoscopic resection of colloid cysts evolved into a currently well-established and appealing minimally invasive alternative to microsurgery. Endoscopic endochannel techniques for colloid cysts of the third ventricle may either be transforaminal or trans-septal interforniceal, depending on the pathoanatomical features of the colloid cyst and its relation to the juxtaposed anatomical structures. The endoscopic trans-septal interforniceal approach is required to access the rare subset of colloid cysts that extend superior to the roof of the third ventricle between the two fornices insinuating themselves between the leaflets of the septum pellucidum. In this article, the surgical technique of the endochannel endoscopic trans-septal interforniceal approach is elaborated upon. A representative case is presented along with an operative video.

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References

  1. Hwang DH, Townsend JC, Ilsen PF, Bright DC (1996) Colloid cyst of the third ventricle. J Am Optom Assoc 67(4):227–234

    CAS  PubMed  Google Scholar 

  2. Jeffree RL, Besser M (2001) Colloid cyst of the third ventricle: a clinical review of 39 cases. J Clin Neurosci 8(4):328–331. https://doi.org/10.1054/jocn.2000.0800

    Article  CAS  PubMed  Google Scholar 

  3. Antunes JL, Louis KM, Ganti SR (1980) Colloid cysts of the third ventricle. Neurosurgery 7(5):450–455. https://doi.org/10.1227/00006123-198011000-00004

    Article  CAS  PubMed  Google Scholar 

  4. Hernesniemi J, Leivo S (1996) Management outcome in third ventricular colloid cysts in a defined population: a series of 40 patients treated mainly by transcallosal microsurgery. Surg Neurol 45(1):2–14. https://doi.org/10.1016/0090-3019(95)00379-7

    Article  CAS  PubMed  Google Scholar 

  5. Maqsood AA, Devi IB, Mohanty A, Chandramouli BA, Sastry KV (2006) Third ventricular colloid cysts in children. Pediatr Neurosurg 42(3):147–150. https://doi.org/10.1159/000091856

    Article  PubMed  Google Scholar 

  6. Kumar V, Behari S, Kumar Singh R, Jain M, Jaiswal AK, Jain VK (2010) Pediatric colloid cysts of the third ventricle: management considerations. Acta Neurochir (Wien) 152(3):451–461. https://doi.org/10.1007/s00701-009-0531-y

    Article  PubMed  Google Scholar 

  7. Vazhayil V, Sadashiva N, Nayak N, Prabhuraj AR, Shukla D, Somanna S (2018) Surgical management of colloid cysts in children: experience at a tertiary care center. Childs Nerv Syst 34(6):1215–1220. https://doi.org/10.1007/s00381-018-3760-7

    Article  PubMed  Google Scholar 

  8. McCrea HJ, Lara-Reyna J, Perera I, Uribe R, Chotai S, Savage N, Hersh EH, Haussner T, Souweidane MM (2021) Colloid cysts of the third ventricle in children. J Neurosurg Pediatr 27(6):700–706. https://doi.org/10.3171/2020.10.PEDS18458

    Article  PubMed  Google Scholar 

  9. Niknejad HR, Samii A, Shen SH, Samii M (2015) Huge familial colloid cyst of the third ventricle: an extraordinary presentation. Surg Neurol Int 6(Suppl 11):S349–S353. https://doi.org/10.4103/2152-7806.161416

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ho KL, Garcia JH (1992) Colloid cysts of the third ventricle: ultrastructural features are compatible with endodermal derivation. Acta Neuropathol 83(6):605–612. https://doi.org/10.1007/BF00299409

    Article  CAS  PubMed  Google Scholar 

  11. Tsuchida T, Hruban RH, Carson BS, Phillips PC (1992) Colloid cysts of the third ventricle: immunohistochemical evidence for nonneuroepithelial differentiation. Hum Pathol 23(7):811–816. https://doi.org/10.1016/0046-8177(92)90352-4

    Article  CAS  PubMed  Google Scholar 

  12. Lach B, Scheithauer BW, Gregor A, Wick MR (1993) Colloid cyst of the third ventricle. A comparative immunohistochemical study of neuraxis cysts and choroid plexus epithelium. J Neurosurg 78(1):101–11. https://doi.org/10.3171/jns.1993.78.1.0101

  13. Brunori A, de Falco R, Delitala A, Schaller K, Schonauer C (2018) Tailoring endoscopic approach to colloid cysts of the third ventricle: a multicenter experience. World Neurosurg 117:e457–e464. https://doi.org/10.1016/j.wneu.2018.06.051

    Article  PubMed  Google Scholar 

  14. Dandy WE (1922) Diagnosis, localization and removal of tumors of the third ventricle. Bull Johns Hopkins Hosp 33:188–189

    Google Scholar 

  15. Hernesniemi J, Romani R, Dashti R, Albayrak BS, Savolainen S, Ramsey C 3rd, Karatas A, Lehto H, Navratil O, Niemelä M (2008) Microsurgical treatment of third ventricular colloid cysts by interhemispheric far lateral transcallosal approach-experience of 134 patients. Surg Neurol 69(5):447–456. https://doi.org/10.1016/j.surneu.2007.11.005. (Epub 2008 Mar 4 PMID: 18295836)

    Article  PubMed  Google Scholar 

  16. Gökalp HZ, Yüceer N, Arasil E, Erdogan A, Dincer C, Baskaya M (1996) Colloid cyst of the third ventricle. Evaluation of 28 cases of colloid cyst of the third ventricle operated on by transcortical transventricular (25 cases) and transcallosal/transventricular (3 cases) approaches. Acta Neurochir (Wien) 138(1):45–49. https://doi.org/10.1007/BF01411723

  17. Solaroglu I, Beskonakli E, Kaptanoglu E, Okutan O, Ak F, Taskin Y (2004) Transcortical-transventricular approach in colloid cysts of the third ventricle: surgical experience with 26 cases. Neurosurg Rev 27(2):89–92. https://doi.org/10.1007/s10143-003-0309-2

    Article  PubMed  Google Scholar 

  18. Konovalov AN, Pitskhelauri DI, Shkarubo M, Buklina SB, Poddubskaya AA, Kolycheva M (2017) Microsurgical treatment of colloid cysts of the third ventricle. World Neurosurg 105:678–688. https://doi.org/10.1016/j.wneu.2017.06.012

    Article  PubMed  Google Scholar 

  19. Powell MP, Torrens MJ, Thomson JL, Horgan JG (1983) Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy. Neurosurgery 13(3):234–237. https://doi.org/10.1227/00006123-198309000-00003

    Article  CAS  PubMed  Google Scholar 

  20. Decq P, Le Guerinel C, Brugières P, Djindjian M, Silva D, Kéravel Y, Melon E, Nguyen JP (1998) Endoscopic management of colloid cysts. Neurosurgery 42(6):1288–1296. https://doi.org/10.1097/00006123-199806000-00051

    Article  CAS  PubMed  Google Scholar 

  21. King WA, Ullman JS, Frazee JG, Post KD, Bergsneider M (1999) Endoscopic resection of colloid cysts: surgical considerations using the rigid endoscope. Neurosurgery 44(5):1103–1111. https://doi.org/10.1097/00006123-199905000-00090

    Article  CAS  PubMed  Google Scholar 

  22. Hellwig D, Bauer BL, Schulte M, Gatscher S, Riegel T, Bertalanffy H (2003) Neuroendoscopic treatment for colloid cysts of the third ventricle: the experience of a decade. Neurosurgery 52(3):525–533. https://doi.org/10.1227/01.neu.0000047671.27057.55

    Article  PubMed  Google Scholar 

  23. Greenlee JD, Teo C, Ghahreman A, Kwok B (2008) Purely endoscopic resection of colloid cysts. Neurosurgery 62(3 Suppl 1):51–56. https://doi.org/10.1227/01.neu.0000317373.00018.6f

    Article  PubMed  Google Scholar 

  24. Dorsch AB, Leonardo J (2017) Use of the swiveling technique for endoscopic removal of a colloid cyst of the third ventricle: a technical note. J Neurol Surg A Cent Eur Neurosurg 78(1):78–81. https://doi.org/10.1055/s-0036-1584828

    Article  PubMed  Google Scholar 

  25. Azab WA, Abdelnabi EA, Mostafa KH (2019) Efficacy and safety of the rotational technique for endoscopic transforaminal excision of colloid cysts of the third ventricle. World Neurosurg 125:e602–e611. https://doi.org/10.1016/j.wneu.2019.01.137

    Article  PubMed  Google Scholar 

  26. Lara-Reyna JJ, Uribe-Cardenas R, Perera I, Szerlip N, Giamouriadis A, Savage N, Haussner T, Souweidane MM (2019) Endoscopic removal of recurrent colloid cysts. J Neurosurg 132(5):1636–1641. https://doi.org/10.3171/2018.12.JNS181859

    Article  PubMed  Google Scholar 

  27. Arjipour M, Gharib M, Eftekharian M (2023) Endoscopic resection of a giant colloid cyst in the velum interpositum: illustrative case. J Neurosurg Case Lessons. 5(1):CASE22381. https://doi.org/10.3171/CASE22381

  28. Tosi U, Uribe-Cardenas R, Lara-Reyna J, Villamater FN, Perera I, Stieg PE, Tsiouris AJ, Souweidane MM (2022) Transseptal interforniceal endoscopic removal of superiorly recessed colloid cysts. J Neurosurg 137(3):813–819. https://doi.org/10.3171/2021.11.JNS211754

    Article  Google Scholar 

  29. Azab WA, Salaheddin W, Alsheikh TM, Nasim K, Nasr MM (2014) Colloid cysts posterior and anterior to the foramen of monro: anatomical features and implications for endoscopic excision. Surg Neurol Int 5:124. https://doi.org/10.4103/2152-7806.138364

    Article  PubMed  PubMed Central  Google Scholar 

  30. Arnaout MM, Elsamman AK (2021) Perspectives on endoscopic transseptal interforniceal approach for retroforaminal colloid cysts. World Neurosurg 152:e71–e80. https://doi.org/10.1016/j.wneu.2021.05.004

    Article  PubMed  Google Scholar 

  31. Lozier AP, Bruce JN (2003) Meningiomas of the velum interpositum: surgical considerations. Neurosurg Focus 15(1):E11. https://doi.org/10.3171/foc.2003.15.1.11

    Article  PubMed  Google Scholar 

  32. Rhoton AL Jr (2002) The lateral and third ventricles. Neurosurgery 51(4 Suppl):S207-271

    PubMed  Google Scholar 

  33. Vinas FC, Dujovny M, Fandino R, Chavez V (1996) Microsurgical anatomy of the arachnoidal trabecular membranes and cisterns at the level of the tentorium. Neurol Res 18(4):305–312. https://doi.org/10.1080/01616412.1996.11740426

    Article  CAS  PubMed  Google Scholar 

  34. Zhang XA, Qi S, Fan J, Huang G, Peng J, Xu J (2012) The distribution of arachnoid membrane within the velum interpositum. Acta Neurochir (Wien) 154(9):1711–1715. https://doi.org/10.1007/s00701-012-1436-8

    Article  PubMed  Google Scholar 

  35. Griffiths PD, Batty R, Reeves MJ, Connolly DJ (2009) Imaging the corpus callosum, septum pellucidum and fornix in children: normal anatomy and variations of normality. Neuroradiology 51(5):337–345. https://doi.org/10.1007/s00234-009-0506-y

    Article  PubMed  Google Scholar 

  36. Rakic P, Yakovlev PI (1968) Development of the corpus callosum and cavum septi in man. J Comp Neurol 132(1):45–72. https://doi.org/10.1002/cne.901320103

  37. Callen PW, Callen AL, Glenn OA, Toi A (2008) Columns of the fornix, not to be mistaken for the cavum septi pellucidi on prenatal sonography. J Ultrasound Med 27(1):25–31. https://doi.org/10.7863/jum.2008.27.1.25

    Article  PubMed  Google Scholar 

  38. Lee J (2008) Cerebral Hemisphere. In: Standring S (ed) Gray’s anatomy: the anatomical basis of clinical practice, 40th edn. Churchill Livingstone, New York, pp 35–360

    Google Scholar 

  39. Beaumont TL, Limbrick DD, Patel B, Chicoine MR, Rich KM, Dacey RG (2022) Surgical management of colloid cysts of the third ventricle: a single-institution comparison of endoscopic and microsurgical resection. J Neurosurg 137(4):905–913. https://doi.org/10.3171/2021.11.JNS211317

    Article  Google Scholar 

  40. Sampath R, Vannemreddy P, Nanda A (2010) Microsurgical excision of colloid cyst with favorable cognitive outcomes and short operative time and hospital stay: operative techniques and analyses of outcomes with review of previous studies. Neurosurgery 66(2):368–375. https://doi.org/10.1227/01.NEU.0000363858.17782.82

    Article  PubMed  Google Scholar 

  41. Grondin RT, Hader W, MacRae ME, Hamilton MG (2007) Endoscopic versus microsurgical resection of third ventricle colloid cysts. Can J Neurol Sci 34(2):197–207. https://doi.org/10.1017/s0317167100006041

    Article  PubMed  Google Scholar 

  42. Symss NP, Ramamurthi R, Kapu R, Rao SM, Vasudevan MC, Pande A, Cugati G (2014) Complication avoidance in transcallosal transforaminal approach to colloid cysts of the anterior third ventriclen: an analysis of 80 cases. Asian J Neurosurg 9(2):51–57. https://doi.org/10.4103/1793-5482.136708

    Article  PubMed  PubMed Central  Google Scholar 

  43. Margetis K, Christos PJ, Souweidane M (2014) Endoscopic resection of incidental colloid cysts. J Neurosurg 120(6):1259–1267. https://doi.org/10.3171/2014.3.JNS131289

    Article  PubMed  Google Scholar 

  44. Azab WA, Najibullah M, Yosef W (2017) Endoscopic colloid cyst excision: surgical techniques and nuances Acta Neurochir (Wien)159(6):1053–1058. https://doi.org/10.1007/s00701-017-3176-2

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Authors and Affiliations

  1. Department of Neurosurgery, Ibn Sina Hospital, Al-Sabah Medical Area, P.O. Box: 25427, 13115, Safat, Kuwait

    Athary Saleem, Mustafa Najibullah, Zafdam Shabbir & Waleed Azab

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  2. Mustafa Najibullah
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  3. Zafdam Shabbir
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Supplementary file1 Video 1 Endoscopic trans-septal interforniceal approach for excision of a colloid cyst of the third ventricle using the rotational technique. (MP4 774667 KB)

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Saleem, A., Najibullah, M., Shabbir, Z. et al. Endoscopic trans-septal interforniceal approach for excision of colloid cysts of the third ventricle using the rotational technique. Childs Nerv Syst 39, 3373–3379 (2023). https://doi.org/10.1007/s00381-023-05990-5

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