J Neurol Surg B Skull Base 2023; 84(S 01): S1-S344
DOI: 10.1055/s-0043-1762328
Presentation Abstracts
Poster Abstracts

Long-Term Results of Endoscopic Endonasal Marsupialization of Rathke's Cleft 2 Cysts with Bioabsorbable Steroid-Eluting Stents: Technical Case Series and 3 Review of the Literature

Christopher P. Carroll
1   Department of Brain and Spine Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, United States
2   Division of Neurosurgery, Department of Surgery, Uniformed Services University of Health Sciences; Bethesda, Maryland, United States
,
Norberto Andaluz
3   Departments of Neurosurgery and Otolaryngology, University of Cincinnati, Cincinnati, Ohio, United States
,
Jennifer Kosty
4   Louisiana State University Health Sciences Center-Shreveport; Shreveport, Louisiana, United States
,
Mario Zuccarello
5   Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, United States
,
Lee Zimmer
6   Mercy Health, Cincinnati, Cincinnati, Ohio, United States
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    Background: Rathke's cleft cysts (RCCs) are common benign skull-base lesions arising from embryologic remnants of Rathke's pouch. Though frequently asymptomatic, RCCs can become symptomatic due to compression of adjacent neural structures. Transcranial and neuroendoscopic surgical treatments have been described for symptomatic RCCs, but recurrence rates remain as high as 30%. Bioabsorbable steroid-eluting (BASE) stents significantly decrease adhesions and recurrent ostia obstruction following endoscopic sinus surgery. We sought to use BASE stents to aid marsupialization of symptomatic RCCs.

    Objective: To present long-term results of our initial experience with endoscopic-endonasal fenestration and placement of BASE stents for RCCs.

    Methods: Patients undergoing neuroendoscopic transsphenoidal fenestration of RCCs with BASE stent placement were identified and their medical records retrospectively reviewed.

    Results: Four patients underwent neuroendoscopic transsphenoidal fenestration and BASE stent placement from January 2016 to April 2018 for symptomatic RCCs. After the cyst contents were evacuated, a BASE stent was deployed in the cyst fenestration to prevent cyst wall regrowth or closure and facilitate marsupialization to the sphenoid sinus. No perioperative complications were encountered, and all patients reported symptom resolution by 2 weeks postoperatively.

    Postoperative endoscopic evaluation at 3 months demonstrated epithelization of the cyst wall opening and patent marsupialization into the sphenoid sinus in all cases. After a mean follow-up of 56 ± 12 months, all patients remained asymptomatic with baseline visual function and no radiographic evidence of recurrence.

    Conclusions: Bioabsorbable steroid-eluting stent placement is a safe, facile, viable augmentation of neuroendoscopic technique for symptomatic Rathke′s cleft cysts with the potential to reduce long-term recurrence rates.


     

    Die Autoren geben an, dass kein Interessenkonflikt besteht.

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    Artikel online veröffentlicht:
    01. Februar 2023

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