Back to Search
Start Over
Recurrent Rathke's Cleft Cysts: Incidence and Surgical Management in a Tertiary Pituitary Center over 2 Decades
- Source :
- Operative neurosurgery (Hagerstown, Md.). 16(6)
- Publication Year :
- 2018
-
Abstract
- BACKGROUND Limited data exist pertaining to outcomes following surgery for recurrent Rathke's cleft cysts (RCC). OBJECTIVE To determine treatment outcomes in patients undergoing reoperation for recurrent or residual RCCs. METHODS A retrospective analysis of 112 consecutive RCC operations in 109 patients between 1995 and 2017 was conducted. RESULTS Eighteen patients underwent 21 RCC reoperations with a mean follow-up of 58 mo. Patient symptoms prior to reoperation included headaches (14, 66.7%) and vision loss (12, 57.1%). Thirteen of 18 patients (72.2%) required hormone supplementation prior to reoperation including 5 with diabetes insipidus (DI). Mean RCC diameter was 16 mm and 76% had suprasellar extension. Compared to index RCC cases, intraoperative cerebrospinal fluid leak repair was more common in reoperation cases (15/21, 71% vs 43/91, 47%, P = .05). There was 1 carotid artery injury without neurological sequelae, and 2 postoperative cerebrospinal fluid (CSF) leaks (9.5%). Rates of transient hyponatremia (3/10, 30% vs 4/91, 4.4%, P = .04) and transient DI (5/10, 50% vs 17/91, 18.7%, P = .04) were higher in the reoperation vs index group. Improved headaches and vision were reported in 4/12 (33%) and 8/12 (61.5%) of RCC reoperation patients, respectively. Two patients developed new permanent DI. A higher proportion of reoperation patients had RCC squamous metaplasia (24% vs 5.4%, P = .02) or wall inflammation (42.9% vs 2.2%, P
- Subjects :
- Adult
Male
Reoperation
medicine.medical_specialty
Microsurgery
medicine.medical_treatment
Hypopituitarism
urologic and male genital diseases
030218 nuclear medicine & medical imaging
Inappropriate ADH Syndrome
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Adrenocorticotropic Hormone
Hypothyroidism
medicine
Humans
Pituitary Neoplasms
Central Nervous System Cysts
Intraoperative Complications
Glucocorticoids
Aged
Cerebrospinal fluid leak
Rathke's cleft cyst
Cerebrospinal Fluid Leak
business.industry
Incidence (epidemiology)
Hypogonadism
Incidence
Middle Aged
medicine.disease
female genital diseases and pregnancy complications
Surgery
Diabetes insipidus
Neuroendoscopy
Female
Neurology (clinical)
Headaches
medicine.symptom
Neoplasm Recurrence, Local
Hyponatremia
business
Carotid Artery Injuries
030217 neurology & neurosurgery
Craniotomy
Diabetes Insipidus
Subjects
Details
- ISSN :
- 23324260
- Volume :
- 16
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Operative neurosurgery (Hagerstown, Md.)
- Accession number :
- edsair.doi.dedup.....d3238703bd4bca8f7a823eed2713a505