Stereotactically guided microsurgical removal of colloid cysts

Summary.

Background. The surgical technique and clinical results for a series of 16 consecutive patients who underwent resection of third ventricular colloid cysts through a stereotactically guided cylindrical retractor are presented.

Methods. Between March 1993 and December 2002, 16 patients, 11 males and 5 females with a mean age of 36, were admitted with colloid cysts of the third ventricle. Four patients had undergone previous surgery, of which two were simple aspirations, one endoscopic aspiration, and one transcallosal partial removal. Four patients required emergency ventriculostomies on admission. In all patients the foramen of Monro was targeted using a Leksell stereotactic frame. A coronal craniotomy three to four cm in diameter was performed and a cylindrical retractor 14 mm in diameter was advanced to the target. Microsurgical removal of the cyst was then performed through the retractor.

Findings. Total removal of the cyst was achieved in all cases. Median follow-up time is 42 months. Complete resolution of symptoms occured in all patients. Control magnetic resonance imaging revealed no residual cysts. All patients have returned to their previous occupations without sequelae or epilepsy.

Conclusion. The outcome obtained in this series has shown that transfrontal transforaminal total removal of colloid cysts through a stereotactically guided cylindrical retractor is a safe procedure.