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Endoscopic Colloid Cyst Resection in the Absence of Ventriculomegaly

Wait, Scott D. MD*,‡,§; Gazzeri, Roberto MD*,¶; Wilson, David A. MD; Abla, Adib A. MD; Nakaji, Peter MD; Teo, Charles MBBS*

doi: 10.1227/NEU.0b013e3182870980
Operative Technique

BACKGROUND: The absence of ventriculomegaly has been considered an overt or relative contraindication to the endoscopic resection of colloid cysts. In the past, endoscopic removal of colloid cysts in the absence of ventriculomegaly has been considered ill advised. Reports of successful endoscopic surgery in small ventricles are surfacing.

OBJECTIVE: We examined the combined experience of 2 high-volume endoscopic centers to characterize the outcomes of patients undergoing endoscopic removal of colloid cysts in small ventricles.

METHODS: We retrospectively reviewed all endoscopic colloid cyst removal procedures by the 2 senior authors (P.N., C.T.) performed at the Barrow Neurological Institute over an 8-year period. Radiographic, clinical, and interview data were recorded and analyzed. The age-adjusted relative bicaudate index was used to define small ventricles.

RESULTS: Sixteen patients (8 female) underwent attempted endoscopic removal of a colloid cyst in the absence of ventriculomegaly. Surgery was technically successful in 15 patients. The cyst was removed completely in 13 of patients. Short-term memory loss was initially present in 3 patients and completely resolved in all but 1 patient who had presented with short-term memory loss. Temporary complications occurred in 2 patients.

CONCLUSION: Normal-size ventricles are not a contraindication to endoscopic removal of third ventricular colloid cysts. Complication rates are at least comparable to those of patients with ventriculomegaly or to those undergoing open microsurgical resection.

*Center for Minimally Invasive Neurosurgery, Prince of Wales Hospital/University of New South Wales, Sydney, Australia;

Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona;

§Department of Neurosurgery, Carolina Neurosurgery and Spine Associates, Levine Children's Hospital, Carolinas Medical Center, Charlotte, North Carolina;

Department of Neurosurgery, San Giovanni-Addolorata Hospital, Rome, Italy

Correspondence: Peter Nakaji, MD, c/o Neuroscience Publications; Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Road; Phoenix, AZ 85013. E-mail:

Received June 5, 2012

Accepted December 18, 2012

Copyright © by the Congress of Neurological Surgeons