鞍上池囊肿的扩大机制和治疗预后分析.

Objective To explore the mechanism of suprasellar arachnoid cyst (SAC）enlargement and determine optimum surgical methods. Methods 72 patients with SAC admitted to Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University from September 2012 to September 2021 were analyzed retrospectively. The patients were divided into localized type (49 cases) and extended type (23 cases). 49 cases were accompanied with varying degree of hydrocephalus. 60 patients underwent endoscopic third ventriculocystocisternostomy (EVCC）through frontal approach. 9 patients underwent endoscopic cystocisternostomy (CC) through temporal approach. 3 patients underwent microscopic CC. The anatomical structure of the cyst walls and cisternal environment were observed. The complication and curative effects were recorded during postoperative follow-up. Results The slit-valves between SAC and basilar artery were found in 49cases during operation and the average age was 48. 8 months. Choroidal heterotopias were found in 17cases during operation and the average age was 9. 7 months. The cyst wall structure of 6 cases were not recorded. The mean clinical follow-up period was (16. 8 ± 13. 6) months. The cure rate was higher for EVCC (100%) than for CC (66. 7%). Hydrocephalus aggravated in 5 cases who improved after ventriculoperitoneal shunt. Conclusions Slit-valve and choroidal heterotopia may play an important role in the mechanism of SAC enlargement. EVCC is a safe and effective modality for this cyst. However,a small number of children with communicating hydrocephalus still need shunt operation. [ABSTRACT FROM AUTHOR]