Clinical Study

Endoscopic Transsphenoidal Cisternostomy for Nonneoplastic Sellar Cysts

Table 4


AC or RCCAuthor and yearCase numbersDecompression methodPacking or reconstruction methodComplicationsRecurrence

AC Dubuisson et al. (2007) [3]9 Microscopically, cyst removed totally (2) and partially (7), communicating with SASAdipose tissue (4/9), bone pieces, biological glue, lumbar puncture drainage1 permanent diabetes insipidus (11%); 2 CSF fistula (22%)FU from 2 months to 324 months, 0 recurrence

AC + RCCCavallo (2008) [2]AC: 10 RCC: 20AC: microscopic or endoscopic, no cyst wall removal; RCC: endoscopic (20), cyst removed totally in purely suprasellar lesion, partially in sellar lesionAC: adipose tissue and/or collagen sponge; RCC: 7 with reconstruction, 13 left openAC: 2 CSF fistula (20%); RCC: 1 thalamic infarction (5%), 2 diabetes insipidus (10%), 1 CSF fistula (5%)AC: FU 10 to 94 months, 1 recurrence (10%); RCC: FU 7 to 70 months, 2 recurrence (10%)

AC Mclaughlin et al. (2012) [6]8 Microscopically or endoscopic approach, no cyst wall removalAdipose tissue, titanium micromesh, fat and collagen buttress, acetazolamide for 48 hoursNo FU 6 to 47 months, 2 recurrence (25%)

RCCBenveniste et al. (2004) [9]62 Microscopically sublabial (37), endonasal (23), endoscopic endonasal (1) craniotomy (1), cyst wall removed totally (6)Adipose tissue (19) + bone piece (55) or titanium mesh (1); left open (6)1 CSF fistula (1.6%), 1 abdominal fat graft harvest infectionFU 1 to 166 months, 10 recurrence (16%)

RCCAho et al. (2005) [10]118 Microscopically sublabial (118), 114 cyst wall removed totally,Adipose tissue (43)22 diabetes insipidus (19%), 1 CSF fistula (0.8%), 1 meningitis (0.8%)FU over 60 months, 21 recurrence (18%)

RCCLillehei et al. (2011) [11]82 Microscopically sublabial and endonasal, simple cyst drainage, alcohol cauterizationGelfoam and bone strut, fibrin glue, spinal drain for intraoperative CSF leakage, 0 adipose tissue packing2 CSF fistula (2.4%), 3 transient DI (3.7%)FU 4 to 163 months, 8 recurrence (9.7%)

RCCPark et al. (2012) [7] 73 Microscopically and endoscopic assisted, cyst drainage 34 packing adipose tissue, 22 packing surgically, 17 no packing, sellar reconstruction with bone, porous polyethylene, TachoComb with BioGlue 2 CSF fistula (2.7%) FU 12–166 months, 12 recurrence (16%)

AC + RCC Oyama et al. (2014) [12] AC: 6; RCC: 1 Microscopically extended approach, cisternostomy 7 dura stitches, no fat packing 1 CSF fistula FU 36 to 49 months, 2 recurrence (28%)

AC + RCC Our series AC: 3; RCC: 5 Endoscopically endonasal, cyst drainage cisternostomy 8 dura stitches, no fat packing, bone and BioGlue 0 CSF fistula FU 4 to 50 months, 1 recurrence (12%)