2026 Poster Presentations
P285: PREDICTORS OF LONG-TERM OUTCOME AND RECURRENCE POST ENDOSCOPIC ENDONASAL RATHKE'S CLEFT CYSTS SURGERY
Sami Khairy; Alejandro Vargas-Moreno; Jessica Rabski; Shaun Kilty; Fahad AlKherayf; University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
BACKGROUND: Rathke’s cleft cysts (RCCs) are benign sellar and suprasellar lesions. Most are treated conservatively, while others require surgery, usually via a transsphenoidal intervention. However, long-term outcomes of surgical intervention remain challenged by the risk of cyst recurrence, which can manifest years after initial treatment. We aim in this study to assess the long-term outcomes of RCCs and predictors of recurrence.
STUDY DESIGN AND METHODS: We reviewed our database for the last 10 years (2014- 2024). We included all the patients with Rathke’s Cleft Cysts who underwent endoscopic endonasal transsphenoidal surgery. Demographic data, preoperative, intraoperative, postoperative clinical data and patients' outcomes were retrospectively collected and analyzed.
RESULTS: Twenty-two RCC patients who underwent transsphenoidal surgery were included in this study. The mean age of our cohort was 54.6 years, and 59% were female. Four patients required reoperation (18.1%). Only one patient developed a cerebrospinal fluid (CSF) leak postoperatively, and two patients (9%) had permanent diabetes insipidus. During follow-up, recurrence was observed in 27% (6 patients) with an average latency of 23 months. Only three were symptomatic and required reoperation. Among all preoperative, intraoperative, and postoperative variables, only the initial size of the RCCs significantly correlated with the risk of recurrence.
CONCLUSIONS: Following transsphenoidal surgery for Rathke's cleft cysts, many patients experienced rapid improvement in symptoms; however, a significant recurrence rate requires long-term follow-up. Among all outcome predictors, the initial cyst size was the sole significant predictor of recurrence. Future studies with larger sample sizes and longer follow-up durations is recommended.