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J Neurol Surg B Skull Base 2023; 84(04): 401-404
DOI: 10.1055/s-0042-1755572
Original Article

Use of Tympanostomy T-Tube for Endoscopic Endonasal Marsupialization of Small Rathke's Cleft Cysts: A Case Series

Anna Lazutkin 
1   Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, United States
,
Ralph Abi Hachem
1   Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, United States
,
Patrick J. Codd
2   Department of Neurosurgery, Duke University, Durham, North Carolina, United States
,
Ali R. Zomorodi
2   Department of Neurosurgery, Duke University, Durham, North Carolina, United States
,
David W. Jang
1   Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, United States
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Abstract

Objectives This article describes a novel technique implementing the use of a tympanostomy t-tube to provide long-term marsupialization of small Rathke's cleft cysts (RCCs).

Design A retrospective review of electronic medical records was performed to collect demographic and clinical data on a series of four patients.

Setting Academic medical center.

Participants Four female patients (mean age of 34 years) underwent transsphenoidal endoscopic endonasal surgery for RCC. All four patients presented with headaches. Mean cyst size was 7 mm. Two of the four surgeries were revisions for RCC recurrence.

Main Outcome Measures Symptom resolution after surgery, duration of follow-up, and feasibility of the proposed technique.

Results Tympanostomy t-tube was used to marsupialize small RCCs (< 10 mm) for four patients. Three patients remained symptom-free with endoscopy and imaging showing patent t-tubes at 21 months' (range 20–24 months) follow-up. One patient experienced severe migraines immediately after surgery. Migraines were relieved after t-tube was removed 6 weeks after surgery.

Conclusion Tympanostomy t-tubes placed via an endoscopic endonasal approach can provide long-term marsupialization for small RCCs.

Keywords

central nervous system cysts - skull base - pituitary


Publication History

Received: 29 January 2022

Accepted: 10 May 2022

Article published online:
09 August 2022

© 2022. Thieme. All rights reserved.

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