Endoscopic transsphenoidal surgery and Haddad nasoseptal flap of Rathke’s cleft cysts

Introduction: Rathke’s cleft cysts (RCC) grow formed from remnants of the embryologic Rathke’s pouch and are often found incidentally in the sellar or suprasellar region. These lesions are usually asymptomatic in most people. However, as the cyst progressively enlarges, they may develop symptoms typical of RCC, including headache, vision loss, and endocrine dysfunction. The diagnosis procedure involves an MRI scan of the pituitary gland. The endoscopic transsphenoidal approach has become the most common surgical approach to treat RCC. In the last 15 years, endonasal endoscopy has been widely used in the surgical management of these lesions. Case report: A 58-year-old Asian woman was reported mainly with a complaint of headache that had increased over the last two months, occasional nausea and vomiting, and blurred vision experienced for 1 month. A contrast brain MRI showed a suprasellar mass consistent with Rathke’s cleft cyst. The patient underwent surgery along with an ophthalmologist to remove the tumor by endoscopic transsphenoidal approach. Conclusion: RCC is a benign lesion that causes symptoms in a minority of patients. Headache, vision loss, and endocrine dysfunction are the most common symptoms. Transsphenoidal surgery is the preferred option for patients with symptoms of RCC.