Abstract:
Background: Arachnoid cysts (ACs) are collections of cerebrospinal fluids (CSFs) that develop within the
arachnoid layer of the meninges. Sellar ACs are comparatively rare. In general, ACs account for approximately
1% of all intracranial mass lesions, and sellar ACs are 3% of all intracranial ACs. An endoscopic transnasal
transsphenoidal approach for the treatment of ACs by fenestrating the cyst’s wall and connecting with the
subarachnoid space is the most optimal option.
Case Description: A 74-year-old woman whose sellar AC was diagnosed on magnetic resonance imaging
a year ago was admitted to our hospital with complaints of bitemporal hemianopia and diminished visual
acuity in the past 2 months. Sellar AC was diagnosed based on the clinical history and presentation, as
well as neurologic, endocrinologic, and ophthalmologic examinations, including visual acuity and visual
field examination, and additional imaging findings. The patient with a sellar/suprasellar AC was treated
by an endoscopic transnasal transsphenoidal approach with cyst drainage and perforation of the lamina
terminalis. Postoperatively, the visual disturbances improved markedly. No surgery‑related complications
occurred.
Conclusion: The endoscopic transnasal transsphenoidal approach remains a minimally invasive and preferred
approach for the treatment of sellar/suprasellar ACs. Hermetically reconstructing the sellar floor is an effective
method to prevent CSF leakage.
