Utilization of sinus stents as a novel approach for benign cystic lesions of the sella

Tamaki, Akina; Shammassian, Berje; Ray, Abhishek; Selman, Warren R.; Rodriguez, Kenneth

doi:10.1016/j.amjoto.2017.06.008

Cited by 8 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In all cases, these techniques are limited to patients in whom intraoperative CSF leak is not encountered. Silicone stenting has been reported as a successful temporary method of maintaining a cyst drainage pathway . Alternatively, steroid‐eluting stents reduce inflammation and prevent fibrosis of the drainage pathway, which contributes to sustained sinus patency .…”

Section: Discussionmentioning

confidence: 99%

“…Silicone stenting has been reported as a successful temporary method of maintaining a cyst drainage pathway . Alternatively, steroid‐eluting stents reduce inflammation and prevent fibrosis of the drainage pathway, which contributes to sustained sinus patency . This decompression with stabilization of the inflamed wall allows for drainage of the RCC and continued symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining

et al. 2019

View full text Add to dashboard Cite

Objectives Rathke cleft cysts (RCCs) are rare, benign lesions formed from remnants of Rathke pouch during embryologic development. However, following marsupialization, maintaining tract patency remains a challenge. Several techniques for decreasing stenosis have been described, including free mucosal grafting, silastic spacing, and using steroid‐eluting stents. Nasoseptal flaps (NSFs) have a reliable vascular supply and are widely utilized in skull base reconstruction. We present a novel technique to maintain patency of the marsupialized RCC cavity by lining it with an NSF to promote long‐term drainage and re‐epithelialization of the RCC cavity. Methods Retrospective chart review of all patients who underwent surgery for symptomatic RCCs. These patients underwent endoscopic endonasal surgery between February 3, 2016, and June 12, 2018, with marsupialization followed by circumferential NSF lining. Primary outcomes include symptomatic control, surgical complications, and RCC cavity patency. Results Seven patients underwent RCC marsupialization with no intraoperative cerebrospinal fluid leak, followed by circumferential lining of the marsupialized cavity with an NSF. In each case, no cyst re‐accumulation or recurrent symptoms were noted, and the NSF lining provided long‐term patency of the tract in all cases to a mean of 6.7 ± 10.1 months of follow‐up, including one patient with sustained patency at 29 months follow‐up. Conclusion Utilization of the NSF to “stent open” the RCC cavity following marsupialization is a safe and effective means to prevent restenosis. Advantages include sustained patency of RCC cavity for complete drainage and a dependable vascular supply. Level of Evidence 4 Laryngoscope, 129:2258–2261, 2019

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Prior reports have demonstrated that these stents dissolve shortly after the procedure, with evidence of complete dissolution at 3 months. 18 , 20 Therefore, although these bioabsorbable stents may be effective at preventing early recurrence, we hypothesize that a nonabsorbable stent may be a more effective option because of the frequency of delayed recurrence. This finding is particularly important because RCCs may recur in either early or delayed fashion.…”

Section: Discussionmentioning

confidence: 99%

“… 17 Recently, a few cases of bioabsorbable stent placement to prevent the recurrence of cystic sellar lesions, including RCCs, have been reported. 18 – 20 However, we present the first case in the literature of nonabsorbable stent placement (in the form of a tympanostomy tube) for recurrent RCCs.…”

mentioning

confidence: 99%

Nonabsorbable intrasellar stent placement for recurrent Rathke cleft cyst: illustrative case

Ellens¹,

Miller²,

Shafiq³

et al. 2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUNDRathke cleft cyst (RCC) has a recurrence rate of 10% to 22%, and preventing recurrence is challenging. For patients who experience persistent recurrence of RCC, placement of steroid-eluting bioabsorbable intrasellar stents has been rarely described. However, recurrences are often delayed, suggesting that dissolvable stents may not be successful long-term. The release of steroids in close proximity to the pituitary gland may also unintentionally influence the hypothalamic-adrenal-pituitary axis.OBSERVATIONSThe authors present a case of a 66-year-old woman with a persistently recurrent RCC who underwent drainage of her cyst with placement of a nonabsorbable intrasellar stent in the form of a tympanostomy tube. After repeat transsphenoidal drainage of her cyst, a tympanostomy T-tube was placed to stent open the dural aperture. Postoperatively, the patient’s condition showed improvement clinically and radiographically.LESSONSPlacement of an intrasellar stent for recurrent RCC has rarely been described. Steroid-eluting bioabsorbable stents may dissolve before RCC recurrence and may have an unintentional effect on the hypothalamic-pituitary-adrenal axis. The authors present the first case of nonabsorbable stent placement in the form of a tympanostomy tube for recurrence of RCC. Additional studies and longer follow-up are necessary to evaluate the long-term efficacy of both absorbable and nonabsorbable stent placement.

show abstract

“…Weitere Fälle einer "off label" Anwendung wurden in der Rhino-Neurochirurgie zur Gewährleistung einer Drainage der Sella bei bestimmten Krankheits-Konstellationen beschrieben (z. B. Kraniopharyngeom-Rezidiv mit stabiler Tumor-Kapsel und Drainage über die Keilbeinhöhle) [34].…”

Section: Ergebnisse Und Diskussionunclassified

Stents und Platzhalter in der endoskopischen endonasalen Nasennebenhöhlenchirurgie

2018

View full text Add to dashboard Cite

In endonasal endoscopic sinus surgery continuous progress has been made in the last decade due to better understanding of microanatomy, gains in adjunctive medicative therapy and technical innovations. Moreover, continuous research and clinical trials on innovative stents and spacers with and without defined drug eluting features may be mentioned in this context. A narrative review of the current development status and its therapeutic options referring to the latter is presented.

show abstract

Utilization of sinus stents as a novel approach for benign cystic lesions of the sella

Cited by 8 publications

References 9 publications

Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining

Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining

Nonabsorbable intrasellar stent placement for recurrent Rathke cleft cyst: illustrative case

Stents und Platzhalter in der endoskopischen endonasalen Nasennebenhöhlenchirurgie

Contact Info

Product

Resources

About