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Outcomes of neuroendoscopy for suprasellar arachnoid cysts: a single center experiences.

BMC Pediatr

December 2024

Division of Pediatric Neurosurgery, Department of Neurosurgery, Faculty of Medicine, Gazi University, Ankara, Turkey.

Background: Arachnoid cysts are extra parenchymal, intra-arachnoid fluid collections of unknown origin, similar in content to cerebrospinal fluid. Suprasellar arachnoid cysts are a rarer localization resulting from abnormalities of the Liliequist membrane or cystic dilatation of the interpeduncular cisterna. We aimed to contribute to the literature by presenting a series of suprasellar arachnoid cyst cases with endoscopic intervention and long-term results.

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  • The study aimed to assess the relationship between visual impairment and suprasellar extension in pituitary macroadenomas using preoperative MRI to identify patients at risk of preoperative visual deficits.
  • Analyzed data from 97 patients revealed that factors like the duration of visual symptoms, specific measurements of suprasellar extension, and the anatomical distortion of the optic nerves were significant predictors of visual impairment.
  • The findings indicate that understanding tumor shape and optic pathway changes can help predict visual impairment risks, which may inform better surgical planning and timing for affected patients.
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  • Giant pituitary prolactinomas can cause rare but severe symptoms, such as acute hypoglossal nerve palsy and neurological decline, as highlighted in a case study of a 62-year-old woman with such a condition.
  • The patient experienced a syncopal episode and difficulties with speech and swallowing, leading to imaging that identified a giant apoplectic pituitary tumor.
  • Urgent surgery to decompress and reduce the tumor resulted in significant improvement in her symptoms, demonstrating the potential benefits of timely surgical intervention and the need for ongoing monitoring.
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  • The study focuses on improving endoscopic endonasal surgery by minimizing nasal damage, particularly on the neglected left side of the nasal cavity.
  • A modified technique is introduced that combines a transseptal approach on the left side and an endonasal approach on the right, allowing for preservation of mucosal integrity.
  • Results from 51 patients show that this combined approach effectively minimizes disruption to the left nasal mucosa while treating various types of sellar and suprasellar lesions.
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