Endocrinopathy, Vision, Headache, and Recurrence After Transsphenoidal Surgery for Rathke Cleft Cysts
| Autor: | Brendan D. Killory, Scott D. Wait, Andrew S. Little, William L. White, Mark P. Garrett |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Vision Disorders Neurological disorder Endocrine System Diseases Preoperative care Neurosurgical Procedures Young Adult medicine Humans Cyst Prospective Studies Rathke Cleft Cysts Rathke cleft cyst Central Nervous System Cysts Child Aged Aged 80 and over Transsphenoidal surgery business.industry Headache Middle Aged medicine.disease Squamous metaplasia Surgery Child Preschool Pituitary Gland Female Neurology (clinical) Headaches medicine.symptom business |
| Zdroj: | Neurosurgery. 67:837-843 |
| ISSN: | 0148-396X |
| DOI: | 10.1227/01.neu.0000374768.16291.03 |
| Popis: | BACKGROUND; Rathke cleft cyst can enlarge and become symptomatic. OBJECTIVE: To review the clinical data and results of all patients treated by the senior author for a Rathke cleft cyst. METHODS: A prospectively maintained surgical database, supplemented with updates from telephone conversations, of all patients presenting to the Barrow Neurological Institute from 1992 to the present was reviewed. RESULTS: Seventy-three patients (17 males, 56 females; mean age, 40 years; range, 5-80 years) underwent 77 resections. The mean length of follow-up was 27 months (range, 0-129 months). Presenting symptoms included headache (75%), followed by endocrinopathy (49%), and visual symptoms (39%). Preoperative chiasmopathy resolved in 75% and improved in 21 % of the patients. Patients' preoperative endocrinopathy resolved at various rates, depending on the specific axis (29%-100%). Endocrinopathies were more likely to resolve in females than males. New postoperative endocrinopathies also occurred (0-8%). Headache resolved (68%) or improved (21 %) in most patients. No patient had worsened headaches. Eight patients had a recurrence, 4 of whom underwent reoperation. The presence of squamous metaplasia was the only predictor of recurrence. CONCLUSION: Surgical fenestration and/or resection of Rathke cleft cyst via the transsphenoidal approach are a rational choice for surgical management of these lesions when symptomatic. In most cases, visual symptoms and headache can be expected to improve. New persistent endocrine deficits can be expected in a small percentage of patients, but preexisting endocrinopathies resolve in many patients. |
| Databáze: | OpenAIRE |
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