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Endoscopic Approach for Colloid Cyst Resection
Published on: May 23, 2025
Endoscopic cyst fenestration outcomes in children one year of age or less
Christian W Sikorski1, Bakhtiar Yamini, David M Frim
1Section of Pediatric Neurosurgery, University of Chicago Children's Hospital, Chicago, Ill., USA.
Insights
Endoscopic fenestration (EF) offers a promising treatment for young children with intracranial cysts. This minimally invasive procedure can successfully avoid or reduce the need for shunting in many infants.
Area of Science:
- Pediatric Neurosurgery
- Minimally Invasive Neurological Procedures
- Cerebrospinal Fluid Disorders
Background:
- Symptomatic intracranial cysts are commonly treated with cerebrospinal fluid (CSF) shunting.
- Shunting in infants under 1 year carries significant risks and complications.
- Limited data exist on the efficacy of endoscopic fenestration (EF) in this young population.
Purpose of the Study:
- To evaluate the clinical outcomes of endoscopic fenestration (EF) in children aged 1 year or younger with symptomatic intracranial cysts.
- To assess the success rate of EF in avoiding or minimizing the need for CSF shunting in infants.
Main Methods:
- Retrospective review of 8 pediatric patients (≤1 year) treated with EF at the institution.
- Inclusion of 17 additional cases from published literature for a total cohort of 26 patients.
- Mean follow-up period of approximately 2.5 years.
Main Results:
- Endoscopic fenestration was successful in 18 out of 26 procedures, either rendering patients shunt-free or minimizing ventricular catheter requirements.
- Eight procedures (30.8%) were considered outright failures.
- The overall success rate suggests EF can be an effective alternative to shunting in this age group.
Conclusions:
- Endoscopic fenestration is a viable and potentially superior initial treatment option for symptomatic intracranial cysts in infants.
- Given the risks associated with shunting in young children, EF should be strongly considered as a primary therapeutic approach.
- Further research with larger cohorts is warranted to solidify these findings.
Abstract:
The use of endoscopic fenestration (EF) is becoming an increasingly common treatment for symptomatic intracranial cysts. Very little data exist regarding outcomes for this procedure in children 1 year of age or younger. We retrospectively reviewed the clinical outcomes of 8 children 1 year of age or less treated at our institution with endoscopic cyst fenestration. The mean follow-up was roughly 2.5 years. These data were combined with 17 other cases obtained from the published literature. EF was successful in rendering patients shunt-free or minimizing the number of ventricular catheters in 18 of 26 operations. There were 8 outright failures -- two in 1 patient. Given the risks and complications of cerebrospinal fluid shunting in children less than 1 year of age, we advocate the consideration of EF as initial treatment of symptomatic intracranial cysts.
