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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Endoscopic transsphenoidal cisternostomy for nonneoplastic sellar cysts
Yukai Su1, Yudo Ishii2, Chien-Min Lin3
1Comprehensive Cancer Center of Taipei Medical University and Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
Biomed Research International
|February 17, 2015
Summary
This study presents a minimally invasive technique for treating sellar arachnoid and Rathke's cleft cysts, demonstrating favorable outcomes in reducing cerebrospinal fluid fistulas and recurrence rates.
Area of Science:
- Neurosurgery
- Endocrinology
- Neurology
Background:
- Sellar arachnoid cysts and Rathke's cleft cysts cause similar symptoms like optochiasmatic compression and pituitary dysfunction.
- Current surgical treatments have limitations, with significant rates of cerebrospinal fluid (CSF) fistula and recurrence.
- Minimizing operative complications and recurrence is crucial for effective management.
Purpose of the Study:
- To present a novel surgical technique for managing sellar arachnoid and Rathke's cleft cysts.
- To evaluate the efficacy of drainage and cisternostomy with dural closure in reducing postoperative complications.
- To assess the impact of this minimally invasive approach on CSF fistula and recurrence rates.
Main Methods:
- A consecutive series of 8 cases involving arachnoid cysts and Rathke's cleft cysts were managed.
- The technique involved cyst drainage and cisternostomy, creating a fenestration into the subarachnoid space.
- Meticulous closure of the sellar floor using dural sutures was performed post-fenestration.
Main Results:
- Postoperative imaging demonstrated favorable outcomes.
- The rates of cerebrospinal fluid (CSF) fistula were significantly reduced.
- Recurrence rates were also found to be favorable following the described procedure.
Conclusions:
- The described technique of drainage and cisternostomy with dural closure is effective for managing sellar cysts.
- This minimally invasive approach offers benefits in reducing postoperative CSF fistulas and cyst recurrence.
- The technique provides a favorable alternative for treating these benign sellar lesions.
