Turkish Neurosurgery
The Utility of Neuroendoscopic Approach for Pineal Region Lesions: Single-Centre Experience
Onur Ozgural 1, Eyup Bayatli1, Halit Anil Eray1, Omer Mert Ozpiskin1, Sena Unal2, Elif Peker2, Melih Bozkurt3, Gokmen Kahilogullari1
1Ankara University Faculty of Medicine, Neurosurgery, Ankara,
2Ankara University Faculty of Medicine, Radiology, Ankara,
3Memorial Bahcelievler Hospital, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.44904-23.4

Aim:Pineal region tumours include parenchymal tumours, germ cell tumours, and neuroecto-dermal tumours. Conventional open, endoscopic, and stereotaxic surgical procedures are the main approaches for providing clinical relief and obtaining a pathological diagnosis. However, the choice is difficult for tumours in deep and critical areas such as the pineal region. We investigated the treatment approaches and follow-up data of patients with pineal region tumours at our institution.Material and Methods:A retrospective study was planned to evaluate patients who diagnosed with a pineal mass between 2019 and 2022 whether incidentally or symptomatically. All patients were evaluated regarding their radiological findings, clinical, labrotary and radiological out-comes of surgery if any performed, intraoperative and postoperative pathological diag-noses, and radiological and symptomatic follow-up results for at least one year. Results:A total of 16 patients were grouped into 2; intervention and conservation groups, re-spectively. Nine out of 16 patients received intervention (surgery with or without ionis-ing radiation therapy) and remained 7 followed up without intervention. Seven patients in the intervention group were found to have triventricular hydrocephalus, and one had tetraventricular hydrocephalus. Endoscopic approach was the preferred surgical inter-vention in all operated patients which was conventional endoscopic third ventriculosto-my (ETV) via a right-sided frontal burr hole. Five patients required a simultaneous ex-ternal ventricular drain. Neuronavigation was used in all the procedures. Conclusion:Neuroendoscopic intervention is a relatively safe, effective, low-cost initial procedure with low morbidity rates and enables patients to return daily life rapidly. Neuroendos-copy is the best approach for simultaneously providing tissue sampling and diversion of cerebrospinal fluid via ETV or septostomy in hydrocephalic patients with tumours in the pineal region.

Corresponding author : Onur Ozgural