Application of flexible neuroendoscopes to intracerebroventricular arachnoid cysts in children: use of videoscopes.

Videoscopes used in other parts of the human body are potential tools for neuroendoscopy as long as they are slim enough, because they provide exceptionally high resolution images. We describe the application of flexible videoscopes and neuroendoscopes developed in Japan to intraventricular arachnoid cysts in children. Thirty-eight children with middle fossa arachnoid cysts were treated either by conventional cystoperitoneal shunting operations (n = 28) or by neuroendoscopes (n = 10). Neuroendoscopic operations such as cyst fenestration were highly useful, eliminating the need for open surgery for cyst excision/fenestration or cystoperitoneal shunting operations in all of the patients during a mean follow-up period of 17.7 months. Statistically highly significant reductions were observed in the major complications (p < 0.0001 by chi(2)-test) because shunting operations were inevitably accompanied by shunt malfunction, infection, or dependence. Compared to the traditional neuroendoscopes, our slim videoscopes provided outstanding image quality, allowing for more comprehensive examination and treatment while minimizing operative trauma.