Pediatrik orta kraniyal fossa araknoid kistlerde uygulanan şant cerrahisinin etkinliği

Amaç: Araknoid kistlerin yarıdan fazlası orta fossa yerleşimlidir. Literatürde tedavi zamanlaması ve şekli konusunda tam bir görüş birliği bulunmamaktadır. Biz kliniğimizde orta kraniyal fossa araknoid kistlerde şant cerrahisi uyguladığımız hastaların sonuçlarını sunarak bu hastaların tedavileri konusuna katkıda bulunmayı amaçladık. Yöntemler: 2015 ve 2021 yılları arasında kliniğimizde orta kranial fossada tip 3 araknoid kist nedeniyle kistoperitoneal şant cerrahisi uyguladığımız 6 hastayı retrospektif olarak inceledik. Tüm hastaların operasyon öncesi ve sonrası klinik ve radyoljik durumları incelenerek not edildi. Operasyon sonrası 1. yıl klinik ve radyolojik kontrolleri de mevcut olan hastalar çalışmaya dâhil edildi. Bulgular: Tüm hastaların araknoid kist yerleşim yeri kranial orta fossa idi ve tüm hastalar kistoperitoneal şant ile tedavi edildiler. 2 yaş altı tüm hastalarda tespit edilmiş şikayet veya bulgu hareket ve tepkilerde azalma ve fontonel gerginliği iken 2 yaş üstünde şiddetli baş ağrısıydı. Tüm hastaların araknoid kistleri sınıflandırmada tip 3’tü ve radyolojik incelemelerde bası bulguları vardı. Hastaların tümünün cerrahi sonrası semptom ve şikayetleri azaldı. Bir hastada slit kist sendromunu düşündürecek klinik bulgular oluştu. Bu hasta dışında hiçbir hastada kontrol süresince herhangi bir komplikasyon görülmedi. Sonuç: Çalışmamız pediatrik orta kraniyal fossa tip 3 araknoid kistli hastalarda kistoperitoneal şant cerrahisinin, ilk tedavi yöntemi olarak da uygulanabilecek etkili ve güvenli tedavi yöntemi olduğu görüşünü desteklemektedir.

Anahtar Kelimeler:

Araknoid kistler, beyin omurilik sıvısı şantları, kraniotomi

Efficacy of shunt surgery in pediatric middle cranial fossa arachnoid cysts

Aim: More than half of arachnoid cysts are located in the middle fossa. There is no consensus in the literature on the timing and type of treatment. We aimed to contribute to the treatment of these patients by presenting the results of patients who underwent shunt surgery in middle cranial fossa arachnoid cysts in our clinic. Methods: We retrospectively reviewed 6 patients who underwent cystoperitoneal shunt surgery for type 3 arachnoid cysts in the middle cranial fossa between 2015 and 2021 in our clinic. The clinical and radiological conditions of all patients before and after the operation were examined and noted. Patients who had postoperative 1st year clinical and radiological controls were included. Results: The arachnoid cyst location of all patients was cranial middle fossa and all patients were treated with cystoperitoneal shunt. The complaint or finding detected in all patients under 2 years of age was fontonal tension and decrease in movement and reactions, while severe headache over 2 years of age. The arachnoid cysts of all patients were type 3 in classification and there were compression findings in radiological examinations. Postoperative symptoms and complaints of all patients decreased. Clinical findings suggestive of slit cyst syndrome occurred in one patient. Except for this patient, no complications were observed during the control period in any of the patients. Conclusion: Our study supports the view that cystoperitoneal shunt surgery is an effective and safe treatment method that can also be applied as the first treatment method in pediatric middle cranial fossa type 3 arachnoid cysts.

Keywords:

Arachnoid cysts, craniotomy, cerebrospinal fluid shunts,

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