Efficacies of neuroendoscopic cystocisternostomy for middle fossa arachnoid cysts in children

Objective To evaluate the efficacies of endoscopic cystocisternostomy in the treatment of middle fossa cysts(MFC) in children. Methods Retrospective analyses were performed for 156 MFC children from January 2007 to December 2013.There were 122 boys and 34 girls with a mean age of 52.8±6.6 months.All children underwent endoscopic cystocisternostomy according to the brain magnetic resonance imaging(MRI) features of suprasellar cistern medial adjacent to cyst.The cysts were left(n=104), right(n=46) and bilateral(n=6). And their types were Ⅰ(3 cysts, one side of bilateral cases), Ⅱ(87 cysts) and Ⅲ(72 cysts) on the basis of the Galassi classification system. Results During a mean follow-up period of 10.3±5.1 months, cyst disappeared in 114 cases(73.1%), shrunk over half in 90.4% cases and diminished in 96.8% cases.Two unchanged cysts were reoperated.Subdural hygroma disappeared in 51% in 3 months and 87.7% in 12 months.Two cases of subdural hygroma underwent subdural-peritoneal shunt.And 7 cases of subdural hematoma had hemorrhagic drainage.No statistical significance existed between the emergence of subdural hygroma and operative age(P>0.05) or between cyst fate and cyst size(P>0.05). Conclusions Adequate communications between cysts and cisterns via a mini-invasive endoscopic fenestration may alleviate cyst compression to brain, improve symptoms and promote brain development.And subdural hygroma and subdural hematoma should be detected timely and watched closely.The prognosis is satisfactory after active interventions. Key words: Cranial fossa, middle; Cyst; Surgical procedure, mini-invasive