Endoscopic vs. Open Microsurgical Excision of Colloid Cysts: A Comparative Analysis and State-of-the-Art Review of Neurosurgical Techniques

Abstract Background The surgical approaches of colloid cysts commonly include endoscopy or open microsurgery. Each approach carries its own challenges, feasibility, and complications. The aim of the current study is to compare endoscopic vs. open microsurgical excision of third ventricular colloid cysts. Methods A retrospective cohort study was conducted to compare the surgical outcomes of endoscopic vs. open microsurgical (Transcortical-transventricular and transcallosal approaches) excision of colloid cyst of the third ventricle at a tertiary care medical institute. All patients with a neuroradiological diagnosis of colloid cyst who subsequently underwent surgical management between January 2003 and June 2020 were included. The neurological outcome was assessed at the last follow-up visit. Results A total of 32 patients with colloid cysts were included in the study. The mean age was 35.8 + 18.3 years (Range = 4-75 years). Female patients slightly outnumbered male patients (N = 17; 53.1%). A total of 21 patients (65.6%) underwent endoscopic resection of the colloid cyst. Complications were encountered in seven patients (Endoscopic, N = 3; Microsurgery, N = 4, p = 0.151). Recurrence was identified in four patients (Endoscopic, N = 3; Microsurgery, N = 1, p = 0.673). Most patients improved neurologically on follow-up visits to the clinic (Endoscopic, N = 19; Microsurgery, N = 9, p = 0.482). Conclusion Both endoscopic and microsurgical approaches provide favorable surgical outcomes in colloid cyst resection. The complications rate between both approaches are statistically insignificant. To date, the optimal surgical approach for colloid cyst resection remains controversial.