title: Success of pure neuroendoscopic technique in the treatment of Sylvian arachnoid cysts in children.
abstract: BACKGROUND
  Neuroendoscopic approaches to Sylvian arachnoid cysts (SACs) constitute an alternative treatment option to craniotomy for fenestration and shunting procedures. In this study, the authors discuss their experience on pure neuroendoscopic technique in the treatment of SACs in children.
  
  
  RESULTS
  The results of treatment of 20 children (range of age, between 7 months and 17 years) with Galassi type II (n, 5) or III (n, 15) SACs who were subjected to pure neuroendoscopic fenestration procedure were presented. It was possible to perform the cystocisternostomy endoscopically in all children with several stomies. The site of the opening was between the optic nerve and the carotid artery in 19, between the carotid artery and the oculomotor nerve in 17, and below the oculomotor nerve in 7. The stomies were enlarged in all cases using the double balloon. Three of the cases required repetition of the operation and two cases required "cystoperitoneal shunt" implantation. There was one minor complication in a patient who had an asymptomatic postoperative subdural effusion, which resolved spontaneously. Of the 18 cases, in which the neuroendoscopic procedures succeeded, 10 showed a reduction in cyst size. The mean follow-up period was 53 months.
  
  
  CONCLUSIONS
  Our results suggest that "pure neuroendoscopic" approach can be used safely in the management of SACs in children. We recommend at least two fenestration sites for an effective marsupialization of the cyst within the basal cisterns. In pediatric cases, the use of a small diameter rigid endoscope allows to reach safely the planned target areas.
authors.affiliation: Department of Neurosurgery, Selcuklu Faculty of Medicine, Selcuk University, Konya, Turkey. hakankarabagli@yahoo.com
authors.forename: Hakan
authors.initials: H
authors.lastname: Karabagli
authors.forename: Volkan
authors.initials: V
authors.lastname: Etus
mesh_terms: D000293:Adolescent; D016080:Arachnoid Cysts / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D035301:Cranial Fossa, Middle / Q000601:surgery; D003399:Craniotomy; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D044583:Neuroendoscopy / Q000379:methods*; D010291:Paresis / Q000209:etiology; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
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