Transsphenoidal endoscopic endonasal approach for the resection of Rathke cleft cysts

Abstract

To evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the resection of Rathke cleft cysts (RCC). Thirty-five pathologically diagnosed RCCs were resected throuth transsphenoidal endoscopic endonasal approach at the HuanHu hospital between January 2000 and December 2011. The clinical data were retrospectively analysed. There were 12 male and 23 female. The average age was 45.7 years and the average disease course was 4.6 years. The typical clinical manifestations included headache (26 cases), visual interference (11 cases) and pituitary dysfunction (8 cases). The postoperative symptoms and follow-up results were recorded. All of the patients underwent complete removal of the cyst contents, complete removal of the cyst wall in 20, fenestration and aspiration of the RCC with partial excision of the cyst wall in 15. The mean cyst volume was (1145.3 ± 12.1) mm(3) [range (121 - 4586) mm(3)]. One patient had cerebrospinal fluid leak, which was repaired using artificial dura mate of brain and gelatin sponge intraoperatively. No postoperative complications were found. Follow-up time ranged from half a year to 11 years. Headache resolved in 100% (26/26), visual interference resolved in 90.9% (10/11), pituitary dysfunction resolved in 62.5% (5/8). No patient recurred. It is concluded that the transsphenoidal endoscopic endonasal approach is microinvasive, safe and effective in the treatment of RCC.