Diagnosis and endoscopic treatment of suprasellar arachnoid cysts in pediatric patients: A case series and analysis of clinical observations

Abstract

Suprasellar arachnoid cysts are rare entities, accounting for approximately 20% of all intracranial arachnoid cysts.

Objective: To evaluate the efficacy of endoscopic ventriculocystostomy and endoscopic ventriculocystocisternostomy in the treatmentof children with suprasellar arachnoid cysts.

Materials and Methods: Between 2016 and 2023, 29 children with suprasellar arachnoid cysts were treated at the Romodanov Institute of Neurosurgery, National Academy of Medical Sciences of Ukraine. The cohort included 18 boys (62%) and 11 girls (38%), with ages ranging from 4 months to 17 years (mean age – 2.8 years). Depending on the surgical technique used, patients were divided into two groups: Group 1 (n=19) underwent endoscopic ventriculocystostomy, and Group 2 (n=10) underwent endoscopic ventriculocystocisternostomy.

Results: The effectiveness of both procedures was confirmed by clinical and radiological assessments. Postoperative hospital stay ranged from 6 to 18 days in Group 1 (mean – 10.2±3.1 days) and from 7 to 17 days in Group 2 (mean – 11.3±3.8 days; p=0.411). The duration of surgery ranged from 25 to 70 minutes (mean – 48.4±13.0 min) in Group 1 and from 45 to 70 minutes (mean – 52.5±8.2 min) in Group 2 (p=0.378). In the early postoperative period, full recovery was observed in 6 patients (33%) in Group 1 and in 2 patients (20%) in Group 2. In the long-term follow-up period, recovery rates were 63% and 70%, respectively. No mortality or disease progression was reported, and no patient required permanent shunt placement. Recurrence occurred in one patient from Group 1.

Conclusions: The analysis of clinical and radiological data demonstrates the effectiveness of both ventriculocystostomy and ventriculocystocisternostomy. Both methods may be recommended for the treatment of suprasellar arachnoid cysts in children due to their minimally invasive nature, low postoperative complication rates, and absence of mortality.