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Accuracy of C-Arm Guided Insertion of Ommaya Reservoir Tube in Recurrent Cystic Craniopharyngiomas

M.D.; Mahmoud Wahdan Mohammed Adawi, M.D. Mohammed Mourad
The Medical Journal of Cairo University , Volume 88, pp 1649-1653; doi:10.21608/mjcu.2020.116258

Abstract: Background: Caniopharyngiomas in spite of being benign tumors they have a high rate of recurrence of which cysts constitute major component. Ommaya Reservoir System (ORS) is a simple manoeuvre for percutaneous drainage of cysts. Aim of Study: To evaluate the efficacy of using C-arm as a guiding tool for placement of Ommaya reservoir tube in predominantly cystic recurrent craniopharyngiomas. Patients and Methods: This study included 8 patients with clinically symptomatic and radiologically confirmed recurrent craniopharyngioma with significant cystic part. These patients were treated by C-arm guided insertion of Ommaya reservoir tube. The technique is described in details. CT brain was obtained in the first post-operative night to assess the position of the tube. Post-operative clinical and radiological evaluations were compared to the pre-operative. Results: This study included 6 males and 2 females, ranging in age from 5 years to 38 years with mean age of 18.4 years. Headache was the most common presenting complaint, followed by visual impairment. All surgeries were performed with C-arm guidance and post-operative CT brain documented satisfactory position of the tube in 7 cases and only one case required second look surgery for repositioning of the tube with the same technique. Significant post-operative improve-ment of headache and visual symptoms were encountered in all cases due to decompression of the optic chiasm by cyst drainage. Conclusion: C-arm assisted insertion of Ommaya reservoir tube is a reliable method that can minimize the errors of free hand technique and of special value in low facility centers.
Keywords: reservoir / Efficacy / tube / cysts / Ommaya / Cyst Drainage / arm guided insertion

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