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J Neurol Surg B Skull Base 2017; 78(02): 112-115
DOI: 10.1055/s-0036-1585088
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Treatment Outcomes of Rathke's Cleft Cysts Managed with Marsupialization

Edward C. Kuan
1   Departments of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, California, United States
,
Frederick Yoo
1   Departments of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, California, United States
,
Jennifer Chyu
1   Departments of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, California, United States
,
Marvin Bergsneider
2   Departments of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, California, United States
,
Marilene B. Wang
1   Departments of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, California, United States
› Author Affiliations
Further Information

Publication History

12 March 2016

27 May 2016

Publication Date:
16 August 2016 (online)

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Abstract

Objectives Rathke's cleft cysts (RCC) are benign cystic lesions of the sella resulting from incomplete obliteration of Rathke's cleft. Symptomatic lesions often require surgical decompression, which is often amenable to a transnasal, transsphenoidal (TNTS) approach. We report our experience with marsupialization of RCC and describe a novel technique to promote re-epithelization of the cyst cavity.

Design Retrospective review.

Setting Tertiary academic medical center.

Participants Patients who underwent TNTS for RCC between 2007 and 2015.

Main Outcome Measures Demographics, lesion characteristics, and reconstruction and treatment outcomes.

Results In total, 52 patients were identified. The mean age was 41 ± 18 years. The mean RCC size was 13 ± 5 mm. Intraoperative cerebrospinal fluid (CSF) leak was encountered in 14 (27%) patients; all were repaired. There were six complications (12%) and no deaths. Mean follow-up was 20 ± 18 months, with five (10%) recurrences. RCC size was associated with intraoperative CSF leak (p = 0.04). In 12 patients, the marsupialized cyst cavity was lined with a free mucosal graft (FMG) to promote healing and re-epithelialization.

Conclusions The TNTS approach is safe and effective in surgical decompression of RCC. Lining the exposed cyst cavity with an FMG is a simple intervention without added morbidity that may promote formation of an epithelialized tract.

Level of Evidence Not applicable.

Keywords

Rathke's cleft cyst - marsupialization - free mucosal grafting

Note

This study was presented orally at the North American Skull Base Society 25th Annual Meeting, February 13, 2016, in Scottsdale, Arizona.


 

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