Abstract：
Rathke\'s cleft cysts (RCCs) are sellar or suprasellar cystic lesions arising from the remnants of the embryological Rathke\'s pouch. When symptomatic, RCCs are usually treated surgically via marsupialization. Free mucosal graft (FMG) repair has shown promise in decreasing recurrence versus marsupialization alone. The authors present a case report with operative video of a patient with visual and endocrinological symptoms with a RCC treated with FMG following marsupialization. A search of the PubMed database from July 1997 through April 2022 was conducted using the terms \'Rathke\'s cleft cyst\', \'Rathke\'s cleft cyst management\', \'Rathke\'s cleft cyst repair\', \'mucosal graft\', \'mucosal coupling\', \'transsphenoidal\', and \'endoscopic endonasal\'. Clinical and pathological aspects of the case presented were compared with information obtained from literature review. A 25-year-old female presented with a six-year history of amenorrhea, one-year history of anemia, headaches, and progressive visual loss. Imaging revealed an RCC. The patient underwent surgical treatment via an endoscopic endonasal approach. Marsupialization was achieved with placement of an FMG to help prevent restenosis. Post-operative examination revealed that the patient\'s OD vision returned to normal, although her OS vision was only slightly improved. Our review of the English literature resulted in 35 full-length articles that were published between 1997 and 2022. The literature suggests that FMG prevents scar formation by allowing for adequate epithelialization, thus decreasing the recurrence rate and being well tolerated by patients. Our findings support the utility of the FMG as a superior surgical treatment option for RCC management.
摘要：
Rathke的裂隙囊肿（RCC）是由Rathke的胚胎性囊残余引起的鞍状或鞍上囊性病变。当出现症状时，RCC通常通过有袋化手术治疗。游离粘膜移植（FMG）修复已显示出减少复发的希望，而不是仅有袋形。作者提供了一个病例报告，其中包括手术视频，该视频显示了患者的视觉和内分泌症状，患有FMG治疗后的RCC。从1997年7月到2022年4月，使用术语“Rathke的裂隙囊肿”对PubMed数据库进行了搜索，\'Rathke\'sleftcybanmanagement\',\'Rathke\'s裂隙囊肿修复\',\'粘膜移植物\',\'粘膜耦合\',\'经蝶窦\',和“鼻内镜”。将该病例的临床和病理方面与从文献综述中获得的信息进行了比较。一名25岁的女性，有六年的闭经史，一年贫血史,头痛,和渐进性视力丧失。成像显示RCC。患者通过鼻内镜入路接受了手术治疗。通过放置FMG以帮助防止再狭窄来实现袋状化。术后检查显示患者的OD视力恢复正常,尽管她的OS视力仅略有改善。我们对英语文献的回顾导致了35篇全长文章，这些文章在1997年至2022年之间发表。文献表明，FMG通过允许适当的上皮形成来防止瘢痕形成，从而降低复发率和患者的耐受性。我们的发现支持FMG作为RCC管理的优越手术治疗选择的实用性。
