Treatment of Rathke's Cleft Cyst
1. Observation
If you are not experiencing any symptoms stemming from your Rathke cleft cyst, it may be best to simply watch the cyst over time and be vigilant for the onset of symptoms. It is possible for you to live your entire life and never experience symptoms from your intact Rathke cleft cyst.

2. Surgery
Surgery is the best form of treatment. Radical or total resection of the cyst is seldom indicated because doing so can damage the pituitary gland. Rather, your surgeon will remove a small portion of the membrane surrounding the cyst and then drain its contents. The contents of the cyst are not infectious or toxic and will not harm your pituitary gland or the tissues around it.

Your surgeon will gain access to your pituitary region through the transsphenoidal approach-so named because the route crosses, or transects, your sphenoid bone. This bone is located behind your nose mostly within your skull.

Using precise surgical instruments, your surgeon will make an incision through your nasal cavity to create an opening in the sphenoid bone. Once your surgeon gains access to your sphenoid sinus, the air-filled area behind the sphenoid bone, further incisions will be made until a hole is created in the sella turcica-the bone that cradles and protects your pituitary gland.

Once your surgeon has your Rathke cleft cyst in the operative field, partial removal and draining of the cyst can proceed. Your surgeon will use high magnification to readily distinguish normal pituitary tissue from the Rathke cleft cyst.

After the entire cyst has been removed, the surgeon will clean the cavity and seal it. At Barrow Neurological Institute at Dignity Health St. Joseph’s Hospital and Medical Center, our surgeons specialize in two types of surgery for Rathke cleft cysts, microsurgery and endoscopic surgery:

Microsurgery uses a powerful operating microscope to help your surgeon distinguish between tiny structures in and around the pituitary gland.
Endoscopic surgery uses small tubes and a tiny camera to help your surgeon remove your tumor in small pieces.

Both aim to minimize trauma to the tissue surrounding your pituitary gland while facilitating a speedy recovery with as little pain or discomfort as is possible. Each technique possesses its own inherent advantages and disadvantages, and your surgeons will work with you to help determine which is the best fit for you.