Moussa A H, Kerasha A A, Mahmoud M E
Department of Neurosurgery, Assiut University Hospital, Assiut, Egypt.
Br J Neurosurg. 2013 Jun;27(3):370-3. doi: 10.3109/02688697.2012.741732. Epub 2012 Nov 20.
Surgical removal (gross total or partial removal), radiotherapy and cyst evacuation have all been used individually or in combination to treat cystic craniopharyngioma, although it is unclear which is the best method.
To report the results of treating cystic craniopharyngioma by insertion of an Ommaya reservoir system (ORS) and aspiration of the cyst.
As from 1990, patients admitted to the neurosurgical department at Assiut University Hospital, Egypt, with grossly cystic craniopharyngioma and who had a single cyst and did not have previous surgery were treated by insertion of an ORS and drainage of the cyst. By 2010, 52 patients had received this treatment with the cystic fluid aspirated completely on the day of surgery. The main presenting symptoms were raised intracranial pressure and visual changes with hormonal changes observed in some patients. The minimal follow-up period was 7 years.
To our surprise, 38 (73%) patients did not develop any recollection of the cyst and showed significant clinical improvement. The only possible explanation is that the part of the catheter of the ORS, with holes in, has established communication between the cyst and the CSF spaces around it after the collapse of the cyst with no adverse effect on the patient at any time. Ten (19%) patients needed reaspiration every 6 months and four (8%) patients showed rapid recollection of cystic fluid and were treated with intracystic bleomycin.
Treatment of cystic craniopharyngioma by drainage through an ORS is very effective. The majority of patients do not need any further treatment. Those who develop re-accumulation of cystic fluid are easily treated by simple aspiration of the fluid through the reservoir. It is a simple and safe method, which lacks the risks associated with surgery or chemotherapy.
手术切除（全切或部分切除）、放射治疗及囊肿穿刺引流均已被单独或联合用于治疗囊性颅咽管瘤，尽管目前尚不清楚哪种方法最佳。
报告通过插入Ommaya储液囊系统（ORS）并抽吸囊肿来治疗囊性颅咽管瘤的结果。
自1990年起，埃及阿斯尤特大学医院神经外科收治的患有巨大囊性颅咽管瘤、仅有一个囊肿且未曾接受过手术的患者，均通过插入ORS并引流囊肿进行治疗。至2010年，52例患者接受了该治疗，术中囊肿液被完全抽吸。主要临床表现为颅内压升高和视力改变，部分患者伴有激素变化。最短随访期为7年。
令人惊讶的是，38例（73%）患者囊肿未复发且临床症状显著改善。唯一可能的解释是，带有小孔的ORS导管部分在囊肿塌陷后使囊肿与周围脑脊液间隙建立了连通，且在任何时候对患者均无不良影响。10例（19%）患者需要每6个月重新抽吸一次，4例（8%）患者囊肿液迅速复发，接受了囊内注射博来霉素治疗。
通过ORS引流治疗囊性颅咽管瘤非常有效。大多数患者无需进一步治疗。那些囊肿液复发的患者通过储液囊简单抽吸液体即可轻松治疗。这是一种简单安全的方法，没有手术或化疗相关的风险。
