The Transcondylar Approach to Access Symptomatic Arachnoid Cysts of the Hypoglossal Canal.

The Transcondylar Approach to Access Symptomatic Arachnoid Cysts of the Hypoglossal Canal.

Oper Neurosurg (Hagerstown). 2018 Feb 01;14(2):E23-E25

Authors: Burkhardt JK, Bal C, Neidert MC, Bozinov O

Abstract
BACKGROUND AND IMPORTANCE: A direct transcondylar approach to treat symptomatic arachnoid cysts of the hypoglossal canal has not yet been described in the literature.
CLINICAL PRESENTATION: Here, we present a skull base approach in 2 female patients (68 and 38 yr) with progressive dysphagia, dysarthria, half-sided weakness, and atrophy of the tongue due to an arachnoid cyst of the hypoglossal canal. After patient informed consent, both patients were successfully operated on without complications using a transcondylar approach, and their symptoms improved 3 mo after surgery; in both patients, resection of the cyst was confirmed using magnetic resonance imaging. Review of the literature revealed 4 surgically treated cases of hypoglossal cysts operated on through a paramedian suboccipital craniotomy from a medial to lateral surgical corridor.
CONCLUSION: This is the first description of the transcondylar surgical approach to safely operate on symptomatic arachnoid cysts located in the hypoglossal canal. The isolated transcondylar approach is useful in selective cases when the pathology is located within the hypoglossal canal only and the skull base anatomy allows a direct approach.

PMID: 29351690 [PubMed - in process]

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