Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
J Neurosurg. 2010 Jun;112(6):1333-9. doi: 10.3171/2009.10.JNS09348.
Rathke cleft cysts (RCCs) are benign lesions that can be diagnosed as an incidental finding associated with headaches, pituitary dysfunction, or vision deterioration. Typically, they occur in a sellar or suprasellar location. The aim of this study was to review the clinical presentation and outcomes associated with endoscopic endonasal resection of these lesions.
The authors retrospectively reviewed a series of 35 patients with a diagnosis of RCC after endoscopic endonasal resection at the University of Pittsburgh between January 1998 and July 2008.
All 35 patients underwent a purely endoscopic endonasal approach (EEA). The average patient age was 34 years (range 12-67 years), and the average follow-up was 19 months (range 1-60 months). Clinical follow-up data were available for 32 patients, and radiographic follow-up data were accessible for 33 patients. All of the patients underwent complete removal of the cyst contents, and according to radiography studies 2 patients had a recurrence, neither of which required reoperation. The mean cyst volume was 1052.7 mm(3) (range 114-6044 mm(3)). Headache was a presenting symptom in 26 (81.2%) of 32 patients, with 25 (96.1%) of 26 having postoperative improvement in their headaches. Fifteen (57.7%) of the 26 patients had complete pain resolution, and 10 (38.5%) had a > 50% reduction in their pain scores. Six (18.8%) of 32 patients initially presented with pituitary dysfunction, although 2 (33.3%) had postoperative improvement. Three (9.4%) of 32 patients had temporary pituitary dysfunction postoperatively, although there was no permanent pituitary dysfunction. Neither were there any intraoperative complications, postoperative CSF leaks, or new neurological deficits. The average hospital stay was 1.8 days (range 1-5 days).
The EEA is a safe and effective approach in the treatment of RCCs. None of the patients in this study experienced any worsening of their preoperative symptoms or pituitary function, and 96% of the patients who had presented with headache experienced complete or significant pain relief following treatment.
Rathke 裂囊肿（RCC）是一种良性病变，可被诊断为与头痛、垂体功能障碍或视力恶化相关的偶然发现。通常，它们发生在蝶鞍或鞍上部位。本研究旨在回顾内镜经鼻入路切除这些病变的临床表现和结果。
作者回顾性分析了 1998 年 1 月至 2008 年 7 月期间在匹兹堡大学接受内镜经鼻入路切除的 35 例 RCC 患者的系列病例。
所有 35 例患者均采用单纯内镜经鼻入路（EEA）。患者平均年龄为 34 岁（12-67 岁），平均随访时间为 19 个月（1-60 个月）。32 例患者有临床随访资料，33 例患者有影像学随访资料。所有患者均行囊肿内容物完全切除，影像学研究显示 2 例复发，均无需再次手术。囊肿平均体积为 1052.7mm³（114-6044mm³）。32 例患者中有 26 例（81.2%）有头痛症状，其中 25 例（96.1%）术后头痛缓解。26 例患者中，15 例（57.7%）完全缓解疼痛，10 例（38.5%）疼痛评分降低>50%。32 例患者中有 6 例（18.8%）最初表现为垂体功能障碍，但术后有 2 例（33.3%）改善。术后 3 例（9.4%）患者出现暂时性垂体功能障碍，但无永久性垂体功能障碍。术中无并发症、术后脑脊液漏或新的神经功能缺损。平均住院时间为 1.8 天（1-5 天）。
EEA 是治疗 RCC 的一种安全有效的方法。本研究中无患者出现术前症状或垂体功能恶化，96%的头痛患者经治疗后完全或显著缓解疼痛。
