Endoscopic management of arachnoid cysts: an advancing technique

Object. Neuroendoscopy is increasingly used in neurosurgery. The authors report their evolving experience in the management of arachnoid cysts using endoscopic techniques and, more recently, the use of these techniques in combination with neuronavigation systems. The aim of this study was to assess the efficacy of this approach and the factors influencing the final outcome of treatment. Methods. The authors reviewed 39 cases in which patients were treated endoscopically for intracranial arachnoid cysts over a period of 8 years. The indications and techniques used were reviewed and the surgical outcomes assessed. There was no death or significant morbidity associated with the procedure. Thirty-six patients had resolution or improvement of symptoms and only three required insertion of a shunt. Conclusions. The treatment of arachnoid cysts has been revolutionized by the introduction of endoscopic techniques. The authors conclude on the basis of their experience that in most cases the combination of neuroendoscopy and frameless navigation represents a safe and reliable modality for treating this benign intracranial entity with minimal surgical trauma. The specific approach should be based on the individual characteristics of each cyst and the surgeon's experience.