Endoscopic Arachnoid Cyst Fenestration

Arachnoid cyst, left temporal

Left temporal arachnoid cyst fenestration (endoscopic fenestration)

Video introducing left temporal arachnoid cyst fenestration using the Little Lott system.

An incision of approximately 3 cm is made in front of the left ear, and the temporalis muscle is retracted. A hole less than 1 cm in diameter is made, and the dura mater is cut. The arachnoid membrane is visible just beneath it. Careful coagulation and fenestraetion must be performed from this point onward. Otherwise, bleeding from unseen blood vessels may occur, making hemostasis difficult.

It is important to enter the cyst and remove or fenestrae as much of the membrane as possible. In particular, the Sylvian fissure and the triangle at the cistern site should be opened to prevent the arachnoid cyst from shrinking and growing again.