Endoscopic Treatment of Intracranial Arachnoid Cysts: A Retrospective Analysis of a 25-Year Experience

2020 ◽  
Vol 20 (1) ◽  
pp. 32-44 ◽  
Author(s):  
Joachim Oertel ◽  
Stefan Linsler ◽  
Wolfgang Wagner ◽  
Michael Gaab ◽  
Henry Schroeder ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Arachnoid Cysts ◽  
Invasive Technique ◽  
Complication Rates ◽  
Patients Âgés ◽  
Endoscopic Techniques ◽  
Long Term Follow Up ◽  
Shunt Dependency

Abstract BACKGROUND Since the development of neuroendoscopy, pure endoscopic fenestration for intracranial arachnoid cysts (ACs) became more and more popular and is actually preferred by many neurosurgeons. OBJECTIVE To explore their techniques and experiences with endoscopic treatment of intracranial ACs over a 25-yr period. METHODS A total of 95 endoscopic procedures in 87 patients with 88 intracranial ACs performed at the authors’ departments between February 1993 and October 2018 were retrospectively analyzed. Particular respect was given to surgical technique, complications, patients’ outcome, and radiological benefit in relation to cyst location. RESULTS Patients’ ages ranged from 23 d to 81 yr (mean: 29.9 yr). Cysts were located temporobasal (n = 31; 35.2%), paraxial supratentorial (n = 14; 15.9%), suprasellar/prepontine (n = 14; 15.9%), quadrigeminal (n = 12; 13.6%), infratentorial (n = 11; 12.5%), and supratentorial intraventricular (n = 6; 6.8%). Four different endoscopic techniques were applied: cystocisternostomies (n = 48; 50.5%), ventriculocystostomies (n = 23; 24.2%), cystoventriculostomies (n = 14; 14.7%), and ventriculocystocisternostomies (n = 10; 10.5%). Pure endoscopic technique was feasible in 89 of the 95 surgeries (93.7%). Clinical improvement was documented after 82 surgeries (86.3%) and radiological benefit after 62 surgeries (65.3%). Recurrences developed in 8 cases (8.4%). Overall complication rate was 21.1% (n = 20), postoperative new shunt dependency was observed in 4.2% of the cases (n = 4). CONCLUSION Pure endoscopic AC fenestration is a safe, effective, and less invasive technique providing high success and low permanent complication rates. The most frequent temporobasal cysts are the most difficult to treat endoscopically. A long-term follow-up is recommended because recurrences may occur many years after first treatment.

Surgical treatment of spinal intradural arachnoid cysts using endoscopy

2010 ◽  
Vol 12 (6) ◽  
pp. 641-646 ◽  
Author(s):  
Toshiki Endo ◽  
Toshiyuki Takahashi ◽  
Hidefumi Jokura ◽  
Teiji Tominaga
Keyword(s):  
Surgical Treatment ◽  
Cyst Wall ◽  
Arachnoid Cysts ◽  
Surgical Approaches ◽  
Endoscopic Techniques ◽  
Long Term Follow Up ◽  
Intradural Arachnoid Cysts ◽  
Cyst Cavity

Object Spinal intradural arachnoid cysts are a rare cause of spinal cord compression. Since 2000, the authors have treated patients using 2- or 3-level hemilaminectomy or laminectomy followed by partial cyst wall resection as well as endoscopic inspection and fenestration of the cyst wall. They evaluated the usefulness and reliability of endoscopic treatment for this clinical entity based on long-term follow-up results. Methods Between 1997 and 2003, 11 patients (3 males and 8 females) with spinal intradural arachnoid cysts were treated, and the authors conducted a retrospective review of these cases. Before 2000, 5 patients were surgically treated without the use of endoscopic techniques. During that time, more than 4 levels of hemilaminectomy were performed to expose and remove cyst walls that extended longitudinally over the spinal axis. Beginning in 2000, endoscopy was used in all 6 cases. Up to 3 levels of hemilaminectomy or 2 levels of laminectomy were performed, and the cyst wall was resected through the bone window. An endoscope was inserted into the cyst cavity and moved in the cranial and caudal direction to fenestrate the cyst wall, resulting in communication of the cyst cavity with the subarachnoid space. Results Postoperatively, the neurological symptoms of all patients improved. During long-term follow-up (mean 114.8 months), none of the patients treated with or without endoscopy experienced recurrent cyst formation. Conclusions Endoscopic techniques allow neurosurgeons to treat spinal intradural arachnoid cysts less invasively than with standard surgical approaches. Although the number of cases reviewed in this report is small, the data suggest that the use of endoscopy can be an important option in the surgical treatment of spinal arachnoid cysts.

Strut remodeling with hypercompliant balloon: A new approach to Y stent-assisted coil embolization in the treatment of complex wide-neck bifurcation aneurysms

2020 ◽  
pp. 159101992098433
Author(s):  
Ali Burak Binboga ◽  
Mehmet Onay ◽  
Cetin Murat Altay
Keyword(s):  
Coil Embolization ◽  
Complication Rates ◽  
Thromboembolic Complications ◽  
New Approach ◽  
Long Term Follow Up ◽  
Safety Effectiveness ◽  
Wide Neck

Background The objective of this study was to present the long-term safety and effectiveness of strand remodelling with a hypercompliant balloon. Methods Patients with complex wide-neck bifurcation aneurysms (WNBAs) who underwent strand remodelling with a hypercompliant balloon via Y-stent-assisted coil embolization (Y-SACE) between September 2016 and January 2020 were included in the study. The feasibility, safety, effectiveness, and complication rates of the strand remodelling technique were investigated. Results A total of 12 patients (6 females, 6 males) were included in this study. Significant expansion was obtained in the intersection zone after remodelling. No regression was observed in the expansion rates during follow-up. There was no additional morbidity or mortality. No delayed thromboembolic complications occurred in our patients during long-term follow-up. Conclusions Performing strand remodelling to reduce thromboembolic complications triggered by structural faults caused by the Y-stent configuration is feasible, safe, and effective. This new approach can aid in the prevention of thromboembolic complications in Y-SACE.

Management of Canine Y-T Humeral Fractures Using Titanium Polyaxial Locking Plates in 17 Dogs

2022 ◽  
Vol 58 (1) ◽  
pp. 7-16
Author(s):  
Claudio Motta ◽  
Philip Witte ◽  
Andrew Craig
Keyword(s):  
Functional Impairment ◽  
Complication Rates ◽  
Load Testing ◽  
Inclusion Criteria ◽  
Long Term Outcomes ◽  
Long Term Follow Up ◽  
Mild Impairment ◽  
Condylar Fractures

ABSTRACT The objective of this study was to document the short- and medium-to-long-term outcomes and complication rates of Y-T humeral condylar fractures fixed using titanium polyaxial locking plate (T-PLP). A retrospective review was performed of the medical records and radiographs of dogs with a Y-T humeral condylar fracture treated with T-PLP at a single veterinary referral center (2012–2018). Seventeen cases met the inclusion criteria. Medium- to long-term follow-up (.6 mo) information was derived using the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Recorded complications were catastrophic (1/17) and minor (2/17). Gait at 10–12 wk following surgery was subjectively assessed as good or excellent for 13 cases. Radiographic bone union was achieved in 7/12 cases at 4–6 wk. LOAD scores obtained a mean of 15 mo (range 6–29 mo) following surgery and indicated no or mild impairment in 15/16 and moderate functional impairment in 1. The application of T-PLP for the treatment of Y-T humeral condylar fractures resulted in adequate stabilization allowing successful fracture healing and medium- to long-term outcomes comparable to previous reports. According to results of LOAD testing, the medium- to long-term follow-up suggests that clients were aware of mild to moderate functional impairment in all cases.

Adductor Spastic Dysphonia: 1 1/2 Years after Recurrent Laryngeal Nerve Resection

1981 ◽  
Vol 90 (1) ◽  
pp. 2-6 ◽  
Author(s):  
Arnold E. Aronson ◽  
Lawrence W. DeSanto
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Physical Effort ◽  
Patients Âgés ◽  
Reduced Volume ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Selection Of

After recurrent laryngeal nerve resection for adductor spastic dysphonia, the voices of 37 patients (ages 39 to 79 years) were assessed 24 hours, 1 month, 6 months, and 1 year after surgery, and those of 33 patients up to 1 1/2 years after surgery. By 24 hours after surgery, 97% of patients had improved and 3% had failed; by 1 month, 97% were still improved while 3% had failed; by 6 months, 92% had maintained improvement while 8% had failed; by 1 year, 68% were still improved but 32% had failed; and by 1 1/2 years, 61% were still improved while 39% had failed. The patients whose voices improved varied from one another in both type and degree of residual dysphonia. The typical postsurgical voice was free of spasm, with some breathiness, hoarseness, and reduced volume being present. The voices of some patients approached normalcy. To most patients, relief from the physical effort to phonate was as important as the improved voice. Continued long-term follow-up studies and careful, collaborative selection of surgical candidates are needed.

scholarly journals VESCICO-URETERAL REFLUX: ENDOSCOPIC TREATMENT, MANAGEMENT AND LONG-TERM FOLLOW-UP

2012 ◽  
Vol 2 (1) ◽  
pp. 44
Author(s):  
A.L Bulotta ◽  
G. Di Maggio ◽  
A. Garzi ◽  
R. Angotti ◽  
E. Cerchia ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Treatment Management ◽  
Long Term Follow Up

Su1707 Endoscopic Treatment of Chronic Pancreatitis in Children: Long Term Follow up

2014 ◽  
Vol 79 (5) ◽  
pp. AB375
Author(s):  
Matteo Napoleone ◽  
Ivo Boskoski ◽  
Pietro Familiari ◽  
Andrea Tringali ◽  
Massimiliano Mutignani ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Treatment ◽  
Long Term Follow Up

OC.17.2 ENDOSCOPIC TREATMENT OF CHRONIC PANCREATITIS IN CHILDREN: LONG TERM FOLLOW UP

2014 ◽  
Vol 46 ◽  
pp. S37
Author(s):  
M. Napoleone ◽  
I. Boskoski ◽  
P. Familiari ◽  
A. Tringali ◽  
V. Perri ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Treatment ◽  
Long Term Follow Up
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