Midha R, Jay V, Smyth H S
Department of Surgery (Neurosurgery), Wellesley Hospital, Toronto, Ontario, Canada.
Surg Neurol. 1991 Jun;35(6):446-54. doi: 10.1016/0090-3019(91)90178-c.
We report detailed data on 10 patients who underwent transsphenoidal microsurgical management of histopathologically confirmed Rathke's cleft cysts. Preoperatively, pituitary dysfunction was present in 90%, headaches in 80%, hyperprolactinemia in 70%, and visual interference in 40%. Computed tomography and magnetic resonance imaging had 90% and 100% sensitivity, respectively, in disclosing the lesion. The mean follow-up duration was 22 months. There was no mortality. The only morbidity was sustained diabetes insipidus in one case. Resolution or improvement in preoperative dysfunction occurred in the majority of patients: headaches in 100%, visual deficits in 75%, normalization of hyperprolactinemia in 83%, and reversal of panhypopituitarism in 33%. We conclude that Rathke's cleft cysts can be managed safely and effectively with transsphenoidal drainage and partial excision of the wall.
我们报告了10例经组织病理学确诊为拉克氏囊肿并接受经蝶窦显微手术治疗患者的详细数据。术前，90%的患者存在垂体功能障碍，80%有头痛症状，70%有高泌乳素血症，40%有视觉障碍。计算机断层扫描和磁共振成像在发现该病变方面的敏感性分别为90%和100%。平均随访时间为22个月。无死亡病例。唯一的并发症是1例持续性尿崩症。大多数患者术前功能障碍得到缓解或改善：头痛缓解率为100%，视觉缺陷改善率为75%，高泌乳素血症恢复正常率为83%，全垂体功能减退逆转率为33%。我们得出结论，经蝶窦引流及部分囊壁切除术可安全有效地治疗拉克氏囊肿。
