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Endoscopic Brain Cyst Excision

Neuro-endoscopy is a relatively new field in neurosurgery that has evolved and allowed for the safe treatment of deep seated tumors in the brain and skull base. A rigid fiberoptic lens with a working channel is used to visualize tumors within the ventricular system of the brain and permit excision or biopsy. Certain brain tumors, such as colloid cysts, are amenable to treatment by neuro-endoscopy.

Colloid cysts are located in a delicate area of the brain and can be life-threatening as they grow. Traditional surgery requires a craniotomy (removal of portion of skull) and retraction of the brain for removal of colloid cysts. Patients who undergo endoscopic resection of these tumors undergo placement of a small incision on the scalp followed by a small opening in the skull (6 mm) to allow for insertion of the endoscope and its associated working channel sheath, measuring 6 mm in maximal diameter. Very small (3-6 mm) endoscopic instruments are used to remove the colloid cyst in its entirety.

Neuro-endoscopy is also used for performing third ventriculostomies for relief of hydrocephalus without placement of a shunt. Certain patients who are candidates enjoy the benefit of not having a shunt, which can malfunction or become infected and eventually require replacement. The procedure, known as an endoscopic third ventriculostomy (ETV) relies on the placement of a hole in the floor of the third ventricle to divert the fluid naturally produced by the brain, CSF, through a different pathway.

Skull base tumors, such as meningiomas and clival chordomas, can be removed by endoscopic assistance through the patient's nose. Placement of the endoscope through the natural orifice of the nare can permit visualization and access to the skull base for removal of deep-seated midline tumors avoiding any skin incision, removal of skull, or brain retraction. Endoscopic access to the skull base is achieved by a team approach between neurosurgeons and otorhinolaryngologists.

Why Choose Emory Neurosurgery?

In most medical centers, colloid cysts are removed with a craniotomy, resulting in a large incision and complete opening of the skull. Emory is the only health care system in Georgia removing these tumors endoscopically through small openings in the skull. What separates us from other brain tumor centers is our ability to apply different technologies for brain tumor resections that other places don't have at this time.

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