Keywords
orbitozygomatic craniotomy - Rathke's cleft cyst - suprasellar - pterional - optic
nerves - MRI - skull base - operative technique
Fig. 1 MR imaging (T2 weighted) demonstrating noncontrast-enhancing cystic lesion in the
sella with suprasellar extension causing compression of both optic nerves in the (A) coronal and (B) sagittal sections. (C–D) Postoperative MR imaging demonstrating adequate debulking in the coronal and sagittal
planes. MR, magnetic resonance.
Fig. 2 Intraoperative images demonstrating (A) cyst decompression using sharp dissection (puncture). The panel also depicts the
relation of the cyst with respect to the right optic nerve (black arrow) and internal
carotid artery (black arrow). (B) Release of cystic contents (thick, red, motor oil-like fluid) following cystic decompression.
(C) Decompression of right optic nerve from the cyst wall followed by (D) separation of the A1 branch of the right anterior cerebral artery (black arrow)
from the tumor capsule. (E) Cyst wall being separated from neurovascular adhesions including left optic nerve
and the left internal carotid artery (black arrow). ICA, internal carotid artery;
ON, optic nerve.
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