Transsphenoidal endoscopic approach in the treatment of Rathke's cleft cyst.
OBJECTIVE
In this study, the usefulness of the transsphenoidal endoscopic approach in the treatment of a Rathke's cleft cyst is reported.


METHODS
Between June 1998 and December 2002, 22 patients affected by sellar-suprasellar Rathke's cleft cysts were treated using a transsphenoidal endoscopic approach. Fourteen patients experienced pituitary dysfunction (64%), five experienced visual impairment (23%), and three reported headaches (14%).


RESULTS
The patient follow-up ranged from 8 to 60 months (mean, 33 mo). Pituitary function was restored only in the four patients with hyperprolactinemia, whereas visual impairment and headache improved in all patients. However, when present before surgery, hypopituitarism was unaffected by surgery. Two patients experienced permanent diabetes insipidus (one of them before surgery). Only one recurrence was observed in a 13-year-old girl at 12 months after surgery, and it was treated using a new transsphenoidal endoscopic approach.


CONCLUSIONS
The transsphenoidal endoscopic approach represents a straightforward and mini-invasive approach for the drainage and biopsy of a Rathke's cleft cyst.
Frank
Giorgio
G
Department of Neurosurgery, Bellaria Hospital, Bologna, Italy. Giorgio.Frank@ausl.bo.it
Sciarretta
Vittorio
V
Mazzatenta
Diego
D
Farneti
Giovanni
G
Modugno
Giovanni Carlo
GC
Pasquini
Ernesto
E
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000601:surgery*; D020863:Central Nervous System Cysts / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures / Q000379:methods; D013100:Sphenoid Bone