Abstract:

Objective To assess the efficacy of endoscopic endonasal transphenoidal microsurgery for the treatment of Rathke’s cleft cysts. Methods A total of 12 cases with pathological diagnosis of Rathke’s cleft cysts who underwent endoscopic endonasal transphenoidal microsurgical treatment were retrospectively analyzed, and the origin, pathogenesis, diagnosis, surgical therapy and prognosis of Rathke’s cleft cysts were investigated by literature review. Results A total of 12 cases with Rathke’s cleft cysts were classified into three types based on anatomy, space-occupying in the sellar region (4 cases), space-occupying in the sellar and suprasellar region (7 cases) and space- occupying in the suprasellar region (1 case). Headache was the predominant pre-surgical symptom (9/12, 75%), and all had improvements in the headache symptoms after surgery. Five cases (41.67% ) had severe reduced vision initially, which improved after surgery. Pituitary
disorders were improved in four cases (33.33% ) following surgery. All cases had no permanent pituitary disorders. One case had post- surgical cerebrospinal leakage, which improved following skull base reconstruction and lumbar cistern drainage. Of the two cases with recurrent Rathke’s cleft cyst, one underwent
surgical therapy again, and the other rejected the surgery. Conclusion Endoscopic endonasal transphenoidal microsurgical therapy is safe and effective for the treatment of Rathke’s cleft cysts, with few post-surgical
complications seen.

Key words: Rathke’s cleft cyst, Endoscopy, Minimally invasive surgery, Therapeutic efficacy