Clinical Analysis Of 90 Cases Of Rathke’s Cleft Cyst

Background and purpose: Rathke’s cleft cysts is a non-neoplastic cystic lesion of the intrasellar or suprasellar space and it is generally considered to be a Rathke’s pouch that does not resolve in the embryonic stage.The cyst is formed when the size of the fissure increases over time and becomes filled with mucus.The incidence rate reported in large-scale routine necropsy is 12-33%,and with the development of medical imaging technology,Rathke’s cleft cysts is found more frequently at all ages.At present,the natural history,pathogenesis,clinical manifestations and prognostic features of Rathke’s cleft cysts still need to be further elucidated.Therefore,in this study,we mainly analyzed the clinical characteristics of patients with Rathke’s cleft cysts.Methods: In this study,we retrospectively analyzed the patients with Rathke’s cleft cysts who received surgical treatment in our hospital from June 2019 to June 2022(n=90),and extracted the clinical data,imaging characteristics,intraoperative findings and pathological results from the patient’s records for statistical analysis.Referring to hardy-wilson pituitary lesion classification,cyst masses were divided into two groups according to the size and location of cysts.Patients in grade I-II were set as the smaller group of cysts(maximum diameter ≤2cm)and patients in grade IIIIV were set as the larger group of cysts(maximum diameter > 2 cm).The differences in age,gender,hospital stay,preoperative symptoms and postoperative symptoms between the two groups were compared and analyzed.Results: In our group of 90 cases of Rathke’s cleft cysts,which were more common in women(76.7%),the main clinical symptoms included headache(55.6%),visual field changes(43.3%),new postoperative pituitary hypofunction(24.4%),and postoperative urinary collapse(33.3%),and the group with larger cysts(maximal diameter >2 cm)was more likely than the group with smaller cysts(maximal diameter ≤2 cm)to have preoperative headache(P=0.025),visual field changes(P=0.021),and more likely to have postoperative symptoms of urosepsis(P=0.031).Conclusion: Rathke’s cleft cysts can cause symptoms such as headache and decreased visual field.The size of the cyst is related to the incidence of headache and visual field changes,and early surgical treatment is needed for patients with obvious clinical symptoms.The larger the cyst,the more likely it will appear hypopituitarism and diabetes insipidus after surgical treatment.Therefore,it is particularly important to grasp the surgical indications and resection range.Individual treatment must be performed for each patient.The advantages and disadvantages should be weighed in each patient,and the higher risk of complications after complete resection and the benefits of symptom elimination should be analyzed.