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Rathke's cleft cyst classification and outcomes after endoscopic endonasal approach.

Hong Kai Wang1, Cheng Chi Lee1, Yu Chi Wang1

  • 1Department of Neurosurgery, Linkou Chang Gung Memorial Hospital, Taoyuan City 333, Taiwan; Chang Gung university, School of Medicine, Taoyuan City 333, Taiwan.

Clinical Neurology and Neurosurgery
|July 30, 2023
PubMed
Summary

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Endoscopic endonasal surgery effectively treats symptomatic Rathke's cleft cysts, improving visual deficits and hormonal imbalances. While generally safe, careful consideration of cyst characteristics is needed for predicting outcomes.

Area of Science:

  • Neurosurgery
  • Endocrinology
  • Ophthalmology

Background:

  • Rathke's cleft cysts are rare sellar region tumors with diverse presentations.
  • A unified classification system for Rathke's cleft cysts is lacking.
  • This study evaluates outcomes of Rathke's cleft cysts treated via endoscopic endonasal approach.

Purpose of the Study:

  • To assess long-term outcomes of symptomatic Rathke's cleft cysts treated with endoscopic endonasal surgery.
  • To analyze outcomes based on different cyst categorization systems (consistency, radiological features).

Main Methods:

  • Retrospective analysis of 38 patients with symptomatic Rathke's cleft cysts.
  • Data collected: clinical presentation, endocrine/visual tests, radiological findings, resection status.
Keywords:
Classification, outcomesEndoscopic endonasal approachRathke’s cleft cyst

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  • Cysts categorized by consistency and radiological features; clinical characteristics analyzed.

    • Main Results:

    • Visual field deficit (65.8%) and hypopituitarism (39.5%) were common pre-operative symptoms.
    • Significant improvement observed in visual field deficit (84%) and hyperprolactinemia (80%).
    • Cyst height correlated with visual deficits and diabetes insipidus; residual cysts predicted recurrence.

    Conclusions:

    • Endoscopic endonasal approach is safe and effective for Rathke's cleft cyst removal.
    • Significant improvements in visual function and hyperprolactinemia were noted.
    • While diabetes insipidus can occur, it's often temporary; cyst categorization aids in predicting hormonal deficits.