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Erschienen in: Pituitary 2/2022

10.01.2022

Surgical outcomes and quality of life in Rathke’s cleft cysts undergoing endoscopic transsphenoidal resection: a multicentre study and systematic review of the literature

verfasst von: Mendel Castle-Kirszbaum, Jeremy Kam, Yi Yuen Wang, James King, Kylie Fryer, Tony Goldschlager

Erschienen in: Pituitary | Ausgabe 2/2022

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Abstract

Objective

To establish the effect of endoscopic endonasal surgery (EES) on quality-of-life (QoL) in symptomatic Rathke cleft cyst (RCC).

Methods

Analysis of 38 patients with RCC treated by EES, with regular overall (ASBQ-35) and sinonasal-specific (SNOT-22) QoL assessment during the first postoperative year. A systematic literature review of large case series was performed with pooled analysis.

Results

In our series, mean age was 53.6 years with a female predominance (73.7%). Larger cysts were seen in males (p < 0.01), those with hypogonadism (p = 0.04), and visual dysfunction (p = 0.04). Complete normalisation of vision was seen in 83.3%. Persistence of visual dysfunction postoperatively was associated with diabetes (p = 0.005), hypertension (p = 0.02), suprasellar only location (p = 0.001), and monocular field cut (p = 0.02). Surgery did not significantly effect hormonal function. Sinonasal QoL transiently worsened after surgery, resolving within 3 weeks. A parallel transient worsening of overall QoL normalised by 6 weeks, and remained at preoperative baseline thereafter. These results were comparable to the literature, where 76.4% demonstrated improvement of vision and 13.1% had recurrence after treatment. There was no significant difference in outcomes between EES and microscopic approaches.

Conclusions

We report longitudinal QoL outcomes in RCC for the first time. Vision commonly improves with surgery, but endocrinopathy is likely to persist. Microvascular risk-factors may compromise visual improvement. Surgery causes a transient worsening of sinonasal symptoms that resolves within 3–6 weeks, but patients may not experience significant improvement in QoL within the first postoperative year.
Literatur
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Zurück zum Zitat Larkin S, Karavitaki N, Ansorge O (2014) Rathke’s cleft cyst. In: Handbook of Clinical Neurology. Elsevier, NY pp 255–269 Larkin S, Karavitaki N, Ansorge O (2014) Rathke’s cleft cyst. In: Handbook of Clinical Neurology. Elsevier, NY pp 255–269
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Zurück zum Zitat Cappabianca P, Cavallo LM, de Divitiis E (2004) Endoscopic endonasal transsphenoidal surgery. Neurosurgery 55:933–940CrossRef Cappabianca P, Cavallo LM, de Divitiis E (2004) Endoscopic endonasal transsphenoidal surgery. Neurosurgery 55:933–940CrossRef
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Zurück zum Zitat Castle-Kirszbaum M, Wang YY, King J, Goldschlager T (2021) Quality of Life Following Endoscopic Surgical Management of Pituitary Adenomas. Neurosurgery 2021 Castle-Kirszbaum M, Wang YY, King J, Goldschlager T (2021) Quality of Life Following Endoscopic Surgical Management of Pituitary Adenomas. Neurosurgery 2021
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Zurück zum Zitat Castle-Kirszbaum M, Kam J, Dixon B, et al Surgical Outcomes and Longitudinal Quality of Life after Endoscopic Endonasal Surgery for Anterior Skull Base Meningioma. Journal of Neurosurgery 2021: Castle-Kirszbaum M, Kam J, Dixon B, et al Surgical Outcomes and Longitudinal Quality of Life after Endoscopic Endonasal Surgery for Anterior Skull Base Meningioma. Journal of Neurosurgery 2021:
Metadaten
Titel
Surgical outcomes and quality of life in Rathke’s cleft cysts undergoing endoscopic transsphenoidal resection: a multicentre study and systematic review of the literature
verfasst von
Mendel Castle-Kirszbaum
Jeremy Kam
Yi Yuen Wang
James King
Kylie Fryer
Tony Goldschlager
Publikationsdatum
10.01.2022
Verlag
Springer US
Erschienen in
Pituitary / Ausgabe 2/2022
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-021-01197-6

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