Neuroendoscopic placement of Ommaya reservoir into a cystic craniopharyngioma

Total removal of the tumor is the most acceptable therapeutic modality in the management of craniopharyngioma; however, there are innumerable factors that can upset treatment plans. Unresectable lesions are often treated with gamma knife surgery (GKS). Reduction of the cystic volume is necessary, to...

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Bibliographic Details
Published in:Child's nervous system 2002-11, Vol.18 (11), p.629-633
Main Authors: JOKI, Tatsuhiro, SHIZUO OI, BABAPOUR, Baback, KAITO, Nobuyoshi, OHASHI, Kazuyoshi, EBARA, Masaki, KATO, Masataka, ABE, Toshiaki
Format: Article
Language:English
Subjects:
Biological and medical sciences
Catheterization - methods
Child
Craniopharyngioma - diagnosis
Craniopharyngioma - diagnostic imaging
Craniopharyngioma - surgery
Endoscopy
Female
Humans
Magnetic Resonance Imaging
Medical sciences
Neoplasm Recurrence, Local
Neurology
Neurosurgical Procedures - methods
Pituitary Neoplasms - diagnosis
Pituitary Neoplasms - diagnostic imaging
Pituitary Neoplasms - surgery
Radiography
Suction - methods
Tumors of the nervous system. Phacomatoses
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Summary:Total removal of the tumor is the most acceptable therapeutic modality in the management of craniopharyngioma; however, there are innumerable factors that can upset treatment plans. Unresectable lesions are often treated with gamma knife surgery (GKS). Reduction of the cystic volume is necessary, to decrease the area to be treated with GKS. An Ommaya reservoir system is usually placed during open surgery or by stereotactic access. The authors use a neuroendoscope for safer and less invasive placement of the Ommaya reservoir into deep-seated cystic lesions. The cystic component is aspirated, and the Ommaya reservoir tube is precisely guided and placed into the cyst cavity under neuroendoscopic control with a newly developed two-burr-hole technique. This neuroendoscopic procedure could make it easier to reduce cystic volume prior to GKS as the final procedure. This technique may also be used for instillation of chemotherapeutic agents and for repeat aspirations, making the achievement of cystic control more likely. This type of neuroendoscopic management is a safe and effective procedure and could be considered as an alternative management technique for some stubborn cystic craniopharyngiomas.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-002-0638-4