Abstract:
Background and Study Aims The treatment of craniopharyngioma is varied. The treatment ranges from radical excision to direct radiotherapy. As the morbidity of excision is high, more conservative approaches are used. Transventricular endoscopy is a minimally invasive treatment for cystic craniopharyngiomas. The objective of this study is to describe a personal experience with this method of treatment. Material and Methods This is a retrospective review of a series of patients managed with endoscopic catheter and reservoir placement for cystic craniopharyngiomas. Results Twenty-nine patients presented with clinical features of raised intracranial features. Imaging showed a predominantly cystic craniopharyngioma extending into the third ventricle with hydrocephalus. All patients underwent transcortical transventricular endoscopic biopsy, and catheter placement connected to a reservoir. There was no morbidity ascribed to the endoscopic procedure when fenestration and aspiration or fenestration and reservoir were placed. Twelve patients underwent radiotherapy. The median duration of follow-up was 18 months (3-72 months). Eight (27.5%) cases had recurrences. Five (17.2%) could be managed with only reaspiration, two (6.8%) required craniotomy and resection, and one (3.4%) could be managed only with ventriculoperitoneal shunt. Conclusion The neuroendoscopic fenestration, aspiration of cyst, and placement of catheter reservoir followed by radiation is an optional treatment for predominantly cystic craniopharyngiomas arising within or extending into the third ventricle causing hydrocephalus.
摘要:
背景与研究目的颅咽管瘤的治疗方法多种多样。治疗范围从根治性切除到直接放疗。由于切除的发病率很高,使用更保守的方法。经脑室内镜是囊性颅咽管瘤的微创治疗方法。这项研究的目的是描述这种治疗方法的个人经历。材料与方法这是一系列患者的回顾性回顾,这些患者使用内窥镜导管和储液器放置治疗囊性颅咽管瘤。结果29例患者表现为颅内突出特征。影像学显示主要是囊性颅咽管瘤,并伴有脑积水。所有患者均经皮质经脑室内镜活检,和导管放置连接到储液器。当放置开窗和抽吸或开窗和储液器时,没有归因于内窥镜手术的发病率。12例患者接受放疗。中位随访时间为18个月(3~72个月)。8例(27.5%)复发。只有五个(17.2%)可以通过重新分配来管理,两人(6.8%)需要开颅手术和切除术,一个(3.4%)只能通过脑室-腹腔分流术进行管理。结论神经内镜开窗术,囊肿抽吸术,和放置导管储液器,然后进行放射治疗是一种可选的治疗方法,主要是在第三脑室内出现或延伸到第三脑室引起脑积水的囊性颅咽管瘤。