Tailored Callosotomy in Third Ventricle Colloid Cyst Resection via Anterior Interhemispheric Transcallosal Approach

Abstract

Background

The colloid cyst represents a relatively uncommon intracranial lesion. It garners significant attention from neurosurgeons due to its benign nature, deep-seated location, and promising prognosis when identified early and surgically removed. A variety of surgical methods are used to treat these cysts, each with their strengths and weaknesses. The aim of this study is to introduce and assess a precise microsurgical technique for managing colloid cysts using the anterior interhemispheric transcallosal approach.

Methods

The research involved a retrospective analysis of 14 cases between 2021 and 2023 treated with the anterior interhemispheric transcallosal approach by 2 experienced skull base surgeons. The evaluation encompassed demographic, clinical, radiological, histological, and surgical data. Additionally, the colloid cyst risk score was used to assess the risk of obstructive hydrocephalus. The procedure incorporated neuronavigation and ultrasound to determine the precise entry point and to plan the trajectory.

Results

The minimally invasive microsurgical technique was effectively employed in all 14 cases, with no reported postoperative complications. Postsurgery magnetic resonance imaging scans confirmed complete cyst removal, with an average callosotomy measurement of 5.4 ± 2.5 mm. Importantly, none of the patients experienced disconnection syndrome associated with callosotomy.

Conclusions

The adapted microsurgical approach via the anterior interhemispheric transcallosal method emerges as a secure and efficient way to address colloid cysts. It ensures comprehensive cyst removal while minimizing complications, boasting advantages such as reduced invasiveness, enhanced visibility, and minimal tissue disturbance, thereby confirming its role in colloid cyst surgical interventions.