内镜开窗治疗有症状的透明隔囊肿

目的 总结内镜开窗治疗有症状的透明隔囊肿的手术技巧与效果.方法 回顾性分析36例采用内镜开窗治疗有症状的透明隔囊肿病人的临床资料,其中采用纵裂-胼胝体入路1例,术前CT定位、枕外侧钻孔经侧脑室三角区入路8例,立体定向引导、额外侧钻孔经侧脑室额角入路27例.结果 所有病人均完成内镜下囊肿开窗操作,透明隔囊肿张力消失,本组无复发和死亡病例.32例随访3个月～7年,病人术前症状明显缓解或消失28例,症状无缓解4例.术后发生并发症4例,其中颅内感染2例,永久性轻偏瘫2例.结论 对有症状的透明隔囊肿,内镜下囊肿单侧壁开窗是一种较为合理的处理方式.立体定向或导航引导经侧脑室额角入路手术更可靠、安全.

Endoscopic fenestration for the treatment of symptomatic septum pellucidum cysts

Objective To summarize the surgical techniques and effectiveness of endoscopic fenestration for treating the symptomatic sepRtm pellucidum cyst. Methods Clinical data of 36 patients with symptomatic septum pellucidum cysts treated by endoscopic fenestration were analyzed retrospectively, including via interhemispheric fissure-corpus callosum approach in 1 patient, via lateral ventricle trigone approach based on preoperative CT localization with lateral occipital drilling in 8 patients, and via lateral ventricle frontal angle approach after frontal drilling guided by stereotactic technique or neuronavigation system in 27. Results The endoscopic fenestration of the septum pellucidum was achieved successfully in all the patients, and the tension of septum pellucidum cysts disappeared. No patients recurred and died. Thirty-two patients were followed up for 3 months to 7 years, the preoperative symptoms disappeared or relieved obviously in 28 patients and not relieved in 4. The postoperative complications occurred in 4 patients, including intracranial infection in 2 and permanent hemiparesis in 2. Conclusions Endoscopic fenestration in the unilateral wall of cyst is a reasonable treatment for symptomatic septtun pellucidum cysts. Lateral ventricle frontal angle approach under guidance by stereotactic technique or neuronavigation system is more reliable and safe.