Turkish Neurosurgery 2014 , Vol 24 , Num 1
Third Ventricle Herniation into the Sphenoid Sinus Following Endoscopic Transnasal Transsphenoidal Fenestration of Rathke's Cleft Cyst
Maryam JALESSI1, Guive SHARIFI2, Amin JAHANBAKHSHI2, Khosro PARSA3, Parin YAZDANIFARD1
1Iran University of Medical Sciences, Hazrat Rasoul Akram Hospital, Endoscopic Pituitary and Skull Base Surgery Unit, ENT-Head and Neck Research Center and Department, Tehran, Islamic Republic of Iran
2Shaheed Beheshti University of Medical Sciences, Loghman Hakim Hospital, Department of Neurosurgery, Tehran, Islamic Republic of Iran
3Iran Mehr Hospital, Department of Neurosurgery, Tehran, Islamic Republic of Iran
DOI : 10.5137/1019-5149.JTN.5991-12.1 Rathke cleft cyst (RCC) is an uncommon albeit benign sellar lesion with an incidence rate of between 2 to 33%. RCCs are usually asymptomatic except in the large cases whit suprasellar extension. We herein describe a unique case of RCC, which presented with severe visual loss owing to massive herniation of the optic chiasm and third ventricle down into the sphenoid sinus through a small 88 mm foramen after transnasal endoscopic surgical fenestration and marsupialization of the cyst. We describe a reconstruction method via endonasal transsphenoidal approach in this case and suggest prophylactic reconstruction of the sellar floor in sellar lesions with equal or more voluminous suprasellar extensions that are susceptible to such massive herniation and secondary empty sella syndrome. Keywords : Rathke cleft cysts, Sella turcica, Secondary empty sella syndrome
Corresponding author : Guive Sharf, gsharifimd@gmail.com