2026 Poster Presentations
P353: NOVEL TECHNIQUE FOR ENDOSCOPIC STENTING OF RATHKE'S CLEFT CYSTS
Ryan A Rimmer; Sacit B Omay, MD; Yale School of Medicine
Introduction: Steroid-eluting stents have been used to maintain patency of endoscopic Rathke's cleft cyst marsupializations and prevent recurrence. Typically, these stents are developed for endoscopic use in the paranasal sinuses for management of inflammatory sinus disease and are not specifically developed for placement in the sella - as such, the deployment device is ergonomically not suited for placing the stent in the sella. Other studies have published using ring curettes currently with the deployment device to guide placement of the stent at the cyst opening. This study proposes a more ergonomic technique for one handed delivery of the stent to prevent Rathke's cleft cyst recurrence.
Methods / Results: Propel mini stents were utilized for stenting after marsupialization of the Rathke's cleft cyst. The stent is compressed per normal protocol but loaded into a disposable 12 Fr fraxier suction device instead of the included deployment device. The trajectory of the frazier suction more directly approaches the sella and allows for more direct delivery (Image 1).
The stent can then be deployed in a controlled, one-handed fashion, by slowly advancing the suction stylet (Images 2 and 3). This technique has been successfully used in 4 patients without cyst recurrence or CSF leak.
Conclusion: Loading propel steroid eluting stents into a frazier suction instead of the included deployment device may allow for more direct, controlled, one-handed delivery of stents to the Rathke's cleft cyst cavity.