“Ventriculocystocisternostomy Vs ventriculocystostomy in the treatment of suprasellar arachnoid cysts: a retrospective case series study”

Abstract Background Suprasellar arachnoid cysts are among the relatively rare cranial lesions that are encountered during neurosurgical practice. Therefore, there is no fixed algorithm for classification, surgical management and evaluation of surgical outcome. The aim of the study is to evaluate the results of endoscopic fenestration of suprasellar arachnoid cysts. Methods Patients with suprasellar arachnoid cysts who underwent endoscopic fenestration at a tertiary referral university hospital between February 2012 and December 2021 were reviewed. Preoperative clinical and radiological data were analyzed. The study included 10 males and 6 females ranged in age from six months to fifteen years. Follow-up period’s average was 19 months. Successful procedure was evaluated by radiological and clinical improvement without any need for further management. Results Ten patients underwent ventriculocystocisternostomy, while six underwent ventriculocystostomy. The overall success rate for endoscopic cyst fenestration was 75%. Ventriculocystocisternostomy was successful in eight of the ten cases (80%), whereas ventriculocystostomy was successful in four of the six cases (66.6%). Complications were two cases of CSF leakage, two cases of ventriculitis, one case of subdural collection, and one case of transient abducent nerve palsy. Conclusion Surgical management for suprasellar arachnoid cyst is reserved only for symptomatic cases. Management via endoscopic fenestration has favorable clinical and radiological outcomes. Ventriculocystocisternostomy is relatively superior to ventriculocystostomy.