Diagnosis and microsurgical treatment of Rathke's cleft cysts

doi:10.3969/j.issn.1671-2897.2002.04.007

Abstract：Objective To discuss the diagnosis and surgical treatment of Rathke's cleft cysts. Methods Forty-one cases of Rathke's cleft cysts verified by microsurgery and pathological results were retrospectively analyzed. Sixteen of them were male and 25 were female. The mean age was 32.8 years. The duration of symptoms was 20.6 months in average. The main clinical manifestations included headache (62.5%), pituitary dysfunctions (55%) and visual disturbance (32%). Computed tomography (CT) and magnetic resonance imaging (MRI) showed cystic mass in the area of sella turcica. Thirty-nine cases underwent microsurgical treatment by transsphenoid approach and 2 cases by craniotomy. In the operation, the contents of the cysts were removed or drained off, and the cyst walls were partially resected and kept open. Results Only 7 cases were correctly diagnosed prior to operation. Post-operative follow-up period ranged from 3 months to 8 years. Headache was completely relieved. Pituitary dysfunction was improved in 55% and visual disturbance in 75%. There was no recurrence. Conclusion It is difficult to establish the correct diagnosis of Rathke's cleft cysts before operation. The MRI signals often vary and show no specificity. Transsphenoidal microsurgery is an effective treatment for the Rathke's cleft cysts since it can relieve the symptoms and give a confirmed diagnosis.