BACKGROUND: A new surgical treatment of middle fossa arachnoid cyst is reported. The benefit of our surgical procedure is to maintain the physiologic pathway of the cerebrospinal fluid (CSF) without a shunting procedure. METHODS: Following a small frontotemporal craniotomy, a linear incision in the outer wall of the cyst is made. The basal subarachnoid cisterns and distal sylvian cisterns are widely opened microsurgically. The outer wall of the cyst is then closed to prevent CSF leakage (arachnoidplasty). RESULTS: We have experienced six patients who underwent this new surgical treatment. All their cysts showed nor or delayed influx of the contrast medium on preoperative computed tomography cisternogram. A favorable outcome was attained in the long-term follow-up without any complications. CONCLUSIONS: The present technique was designed to secure physiologic CSF circulation and to avoid the use of a shunting system. A total of six patients treated with our new technique have been followed-up 6 years, and a good clinical outcome has been observed in all of them without complications.
BACKGROUND: A new surgical treatment of middle fossa arachnoid cyst is reported. The benefit of our surgical procedure is to maintain the physiologic pathway of the cerebrospinal fluid (CSF) without a shunting procedure. METHODS: Following a small frontotemporal craniotomy, a linear incision in the outer wall of the cyst is made. The basal subarachnoid cisterns and distal sylvian cisterns are widely opened microsurgically. The outer wall of the cyst is then closed to prevent CSF leakage (arachnoidplasty). RESULTS: We have experienced six patients who underwent this new surgical treatment. All their cysts showed nor or delayed influx of the contrast medium on preoperative computed tomography cisternogram. A favorable outcome was attained in the long-term follow-up without any complications. CONCLUSIONS: The present technique was designed to secure physiologic CSF circulation and to avoid the use of a shunting system. A total of six patients treated with our new technique have been followed-up 6 years, and a good clinical outcome has been observed in all of them without complications.