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  • Title: Navigator system-assisted endoscopic fenestration of a symptomatic cyst in the septum pellucidum--technique and cases report.
    Author: Chiu CD, Huang WC, Huang MC, Wang SJ, Shih YH, Lee LS.
    Journal: Clin Neurol Neurosurg; 2005 Jun; 107(4):337-41. PubMed ID: 15885396.
    Abstract:
    Expanding cysts of the septum pellucidum are rare and frequently manifest as intermittent headaches. Although the technique of endoscopic fenestration has been used since 1999, only a limited number of cases have been reported. We have added the use of a navigator system to guide keyhole creation and endoscopic access. To provide experience in navigator endoscopic treatment of symptomatic cyst of septum pellucidum and long-term follow-up of the surgical result. Under the guidance of the navigator system, a burr hole was made and rigid endoscope was inserted into the lateral ventricle through a working sheath. With direct visualization, only one side of the lateral wall of the cyst was fenestrated. And a grasping basket was used to further dilate the perforated hole. Patient A, a 14-year-old male adolescent, had an acute onset of severe headache with increased intracranial pressure. Patient B was a 37-year-old woman with a diagnosis of medically intractable migraine. Both patients experienced dramatic symptomatic relief after surgery at 4.5- and 2-year follow-up exams, respectively. The technique of navigator-assisted endoscopic fenestration in the treatment of a symptomatic cyst of the septum pellucidum might be a safe and effective method. It achieved satisfactory results in our two patients.
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