Background: Colloid cysts of the third ventricle are rare, benign lesions that may cause life-threatening obstructive hydrocephalus. Full-endoscopic resection has emerged as a minimally invasive alternative to microsurgical approaches. This study evaluates the surgical outcomes and safety profile of the trans-frontal endoscopic technique, with emphasis on the swiveling technique for capsule excision. Methods: This retrospective and prospective cohort study included 24 patients who underwent full-endoscopic trans-frontal resection of third ventricular colloid cysts at Al- Ahrar Teaching Hospital, a tertiary neurosurgical center in Egypt, between January 2016 and December 2024. All procedures were performed using a 6° angled rigid neuroendoscopy with a 3.1 mm working channel. Initial aspiration of contents followed by capsule removal which was facilitated using the swiveling technique, which involves rotational dissection following firm grasping of the cyst wall. Clinical, radiological, intraoperative, and postoperative outcome data were systematically collected and analyzed. Results: The mean patient age was 28.3 ± 7.8 years. Headache was the most common symptom (75%), and hydrocephalus was present in 79.2% of patients. Gross total resection (GTR) was achieved in 87.5% of patients, while the remainder underwent subtotal resection. One patient (4.2%) required postoperative ventriculoperitoneal shunting. Postoperative complications included transient memory disturbance in 8.3% of patients. No perioperative mortality or recurrences were detected within 24 months. Conclusion: Endoscopic resection of third ventricular colloid cysts is a safe and effective technique with high rates of total resection and minimal morbidity. The swiveling technique facilitates safe capsule removal and restoration of cerebrospinal fluid flow.
M. Soliman (Wed,) studied this question.