Cystosphenoid Stenting for Rathke Cleft Cysts

Objectives: To describe a technique to prevent reaccumulation of Rathke cleft cysts (RCC) after endoscopic endonasal surgery. Study Design: Retrospective chart review. Methods: Patients who underwent endoscopic endonasal surgery for RCC with stent placement from 2012 to 2013 were identified. Demographics, outcomes, and complications were recorded. Results: Five patients were identified. Mean age was 24 years, and mean follow-up was 9.7 months (range 3-16). Two patients had undergone a previous RCC with recurrence. Stents were removed at 1 month postoperatively in three patients. One patient has an asymptomatic retained stent and is being observed; one required revision surgery for cyst recurrence and a retained stent. There has been one minimal, asymptomatic recurrence that has not required revision. No patient developed a postoperative CSF leak or permanent endocrinopathy. Conclusions: Rathke cleft cysts are benign sellar lesions that have a small, but not infrequent, rate of recurrence. The use of retrievable stents may decrease restenosis but postoperative scarring may prevent retrieval and contribute to cyst recurrence. Further study in a larger cohort is warranted.