Long‐Term Outcomes and Recurrence of Rathke’s Cleft Cysts Post Endoscopic Endonasal Resection

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 to assess the long‐term outcomes of RCCs and predictors of recurrence post endoscopic endonasal resection.

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 (EET) surgery. Demographic data, preoperative, intraoperative, postoperative clinical data and patients’ outcomes were retrospectively collected and analyzed.

Thirty RCC patients who underwent transsphenoidal surgery were included in this study. The mean age of our cohort was 54.6 years, and 59% were females. Four patients developed cerebrospinal fluid (CSF) leak postoperatively (13.33%), and four patients (13.33%) had permanent diabetes insipidus (DI). During follow‐up, recurrence was observed in 16.67% (5 patients) with an average latency of 23 months. Only three patients were symptomatic and required re‐operation.

Following transsphenoidal surgery for Rathke’s cleft cysts, many patients experienced rapid improvement of symptoms. Moreover, recurrence is influenced by numerous factors requiring long‐term follow‐up. Future studies with larger sample sizes and longer follow‐up durations are recommended.