雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Treatment of Rathke's Cleft Cyst:Technical Note for Preservation of Pituitary Function Miiko ITO 1 , Kenichiro MATSUDA 1 , Atsushi KUGE 1 , Shinya SATO 1 , Takamasa KAYAMA 1 , Yukihiko SONODA 1 1Department of Neurosurgery, Faculty of Medicine, Yamagata University Keyword: preservation of pituitary function , Rathke's cleft cyst , 30° endoscope , small fenestration of sellar floor , sagittal view of T1WI with Gd-DTPA pp.313-317
Published Date 2018/4/10
DOI https://doi.org/10.11477/mf.1436203722
  • Abstract
  • Look Inside
  • Reference

 Pituitary dysfunction, such as panhypopituitarism or diabetes insipidus(DI), is often found in patients with Rathke's cleft cyst. Patients were treated with transsphenoidal microscopic surgery;however, pituitary dysfunction did not usually recover. Recently, endoscopic transsphenoidal surgery(eTSS)has enabled minimally invasive surgery for patients with Rathke's cleft cyst.

 In this study, we analyzed 22 consecutive patients with Rathke's cleft cyst who underwent eTSS to determine if pituitary dysfunction recovered. The follow-up period ranged from 3 months to 19.25 years(mean, 4.75 years). Preoperative endocrinological evaluation showed impaired secretion of adrenocorticotropic hormone(ACTH)in 4 cases(18.2%), thyroid-stimulating hormone(TSH)in 2 cases(9.1%), hyperprolactinemia in 5 cases(22.7%), growth hormone(GH)in 9 cases(40.9%), and luteinizing hormone(LH)/follicle-stimulating hormone(FSH)in 11 cases(50%). In addition, preoperative DI was found in 2 cases(9.1%). We planned the site of fenestration for the cyst wall using preoperative sagittal magnetic resonance imaging. As a result, the recovery rate for ACTH, GH, and TSH secretion was 25%, 33.3%, and 50%, respectively. On the other hand, two patients with DI and other hormonal deficiencies did not recover pituitary function because of severe inflammation.

 Pituitary function might be preserved with minimally invasive surgery for Rathke's cleft cyst with mild inflammation.


Copyright © 2018, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

関連文献

もっと見る

文献を共有