Endoscopic Treatment of Sellar Arachnoid Cysts via a Simple Cyst-Opening Technique: Long-Term Outcomes From a Single Center

Kalyvas, Aristotelis; Milesi, Matthias; Leite, Matheus; Yang, Kaiyun; Jacques, Leslie St.; Vescan, Allan; Mete, Özgür; Ezzat, Shereen; Zadeh, Gelareh; Gentili, Fred

doi:10.1016/j.wneu.2022.02.072

Cited by 7 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several surgical approaches have been described for treating sellar ACs, such as transcranial (pterional, frontotemporal, orbitofrontal, or subfrontal) and transsphenoidal (endoscopic or microscopic) approaches. [1,5,17,21,25,28,33,44] Aljuboori et al used the orbitofrontal approach in the treatment of sellar ACs because of the minimal frontal lobe retraction, adequate space for cyst fenestration and a lower risk of CSF leakage than TS. [1] Shim and colleagues have described a transventricular endoscopic fenestration of intrasellar AC.…”

Section: Discussionmentioning

confidence: 99%

“…[33] e clinical presentation of 128 cases with sellar/suprasellar ACs is summarized in Table 2. [4][5][6][7]9,[11][12][13][14]16,21,22,[25][26][27][28][31][32][33][34]37,38,[40][41][42]44,45,[47][48][49] e 50 males and 66 females were aged 16-80. Headache 44 patients and visual disturbance 78 patients were the complaints of most patients.…”

Section: Improved Visual Acuitymentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic transnasal transsphenoidal management of sellar/suprasellar arachnoid cyst: A case report and literature review

Matmusaev

Watanabe

Iwami

et al. 2023

Surgical Neurology International

View full text Add to dashboard Cite

Background: Arachnoid cysts (ACs) are collections of cerebrospinal fluids (CSFs) that develop within the arachnoid layer of the meninges. Sellar ACs are comparatively rare. In general, ACs account for approximately 1% of all intracranial mass lesions, and sellar ACs are 3% of all intracranial ACs. An endoscopic transnasal transsphenoidal approach for the treatment of ACs by fenestrating the cyst’s wall and connecting with the subarachnoid space is the most optimal option. Case Description: A 74-year-old woman whose sellar AC was diagnosed on magnetic resonance imaging a year ago was admitted to our hospital with complaints of bitemporal hemianopia and diminished visual acuity in the past 2 months. Sellar AC was diagnosed based on the clinical history and presentation, as well as neurologic, endocrinologic, and ophthalmologic examinations, including visual acuity and visual field examination, and additional imaging findings. The patient with a sellar/suprasellar AC was treated by an endoscopic transnasal transsphenoidal approach with cyst drainage and perforation of the lamina terminalis. Postoperatively, the visual disturbances improved markedly. No surgery-related complications occurred. Conclusion: The endoscopic transnasal transsphenoidal approach remains a minimally invasive and preferred approach for the treatment of sellar/suprasellar ACs. Hermetically reconstructing the sellar floor is an effective method to prevent CSF leakage.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Improved Visual Acuitymentioning

confidence: 99%

Endoscopic transnasal transsphenoidal management of sellar/suprasellar arachnoid cyst: A case report and literature review

Matmusaev

Watanabe

Iwami

et al. 2023

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

“…Typically, growing or symptomatic RCCs are treated via a trans-sphenoidal approach [ 2 ]. Similar to other sellar lesions and also other intracranial cystic lesions in adults and pediatric patients, the endoscopic techniques have become the preferable option by most institutions in the last decades [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Treatment of Rathke’s Cleft Cysts: The Case for Simple Fenestration

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background: Rathke’s cleft cysts (RCC) arise from the pars intermedia because of incomplete regression of the embryologic Rathke pouch. A subset of RCC becomes symptomatic causing headaches, visual and endocrinological disturbances such that surgical intervention is indicated. Several points in surgical management remain controversial including operative strategy (simple fenestration (SF) vs complete cyst wall resection (CWR)) as well as reconstructive techniques. Methods: A retrospective analysis was conducted of pathologically confirmed RCC operated on by endoscopic endonasal approach from 2006 to 2019. Pre-operative symptoms, imaging characteristics, operative strategy, symptom response, complications and recurrences were recorded. Results: Thirty-nine patients were identified. Thirty-three underwent SF and six underwent CWR. Worsening pituitary function was significantly increased with CWR (50%) compared to SF (3%) (p = 0.008). All patients underwent “closed” reconstruction with a post-operative CSF leak rate of 5% (3% SF vs 16% CWR, p = 0.287). Six (15%) recurrences necessitating surgery were reported. Recurrence rates stratified by surgical technique (18% SF vs 0% CWR, p = 0.564) were not found to be significantly different. Conclusions: The current series illustrates variability in the surgical management of RCCs. SF with closed reconstruction is a reasonable operative strategy for most symptomatic RCCs cases while CWR can be reserved for selected cases.

show abstract

“…1-3 When surgery is needed, it is usually performed through the endoscopic endonasal approach. 4-6 However, some features of the cyst may suggest a transcranial route as a better alternative. We presented the case of a 28-year-old woman with a sellar and suprasellar arachnoid cyst, which displaced the pituitary gland and the optic chiasm cranially.…”

mentioning

confidence: 99%

Anatomic and Surgical Considerations in the Management of a Sellar and Suprasellar Arachnoid Cyst: 2-Dimensional Operative Video

Rychen,

Constanzo,

Chan

et al. 2024

Operative Neurosurgery

View full text Add to dashboard Cite

Arachnoid cysts of the sellar region are rare. [1][2][3] When surgery is needed, it is usually performed through the endoscopic endonasal approach. 4-6 However, some features of the cyst may suggest a transcranial route as a better alternative. We presented the case of a 28-year-old woman with a sellar and suprasellar arachnoid cyst, which displaced the pituitary gland and the optic chiasm cranially. By going through an endoscopic endonasal approach, the cyst could be easily opened; however, fenestration into the basal cisterns would be fairly limited and therefore increasing the risk of recurrence. Furthermore, pituitary function and cranial nerve integrity would be at risk. By going through a transcranial route, we circumvented these problems and were able to achieve wide fenestration into multiple basal cisterns. [7][8][9] In this video, we discussed how the goal of surgery, the particular characteristics of the lesion, and anatomic features of the patient should dictate the surgical approach. The patient consented to the procedure and to the publication of her images.

show abstract

Endoscopic Treatment of Sellar Arachnoid Cysts via a Simple Cyst-Opening Technique: Long-Term Outcomes From a Single Center

Cited by 7 publications

References 30 publications

Endoscopic transnasal transsphenoidal management of sellar/suprasellar arachnoid cyst: A case report and literature review

Endoscopic transnasal transsphenoidal management of sellar/suprasellar arachnoid cyst: A case report and literature review

Endoscopic Treatment of Rathke’s Cleft Cysts: The Case for Simple Fenestration

Anatomic and Surgical Considerations in the Management of a Sellar and Suprasellar Arachnoid Cyst: 2-Dimensional Operative Video

Contact Info

Product

Resources

About