{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:41:54Z","timestamp":1791906114052,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>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\u2010eluting 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\u2010term drainage and re\u2010epithelialization of the RCC cavity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2010accumulation or recurrent symptoms were noted, and the NSF lining provided long\u2010term patency of the tract in all cases to a mean of 6.7 \u00b1 10.1 months of follow\u2010up, including one patient with sustained patency at 29 months follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Utilization of the NSF to \u201cstent open\u201d 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:2258\u20132261, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28053","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T03:05:14Z","timestamp":1556679914000},"page":"2258-2261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3475-0718","authenticated-orcid":false,"given":"Edward C.","family":"Kuan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine Medical Center  Orange California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica S.","family":"Trent","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine Medical Center  Orange California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5600-4938","authenticated-orcid":false,"given":"Neil N.","family":"Luu","sequence":"additional","affiliation":[{"name":"and the Department of Otolaryngology\u2013Head and Neck Surgery, University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Kohanski","sequence":"additional","affiliation":[{"name":"and the Department of Otolaryngology\u2013Head and Neck Surgery, University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4471-5134","authenticated-orcid":false,"given":"Charles C.","family":"Tong","sequence":"additional","affiliation":[{"name":"and the Department of Otolaryngology\u2013Head and Neck Surgery, University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Bert W.","family":"O'Malley","sequence":"additional","affiliation":[{"name":"and the Department of Otolaryngology\u2013Head and Neck Surgery, University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"and the Department of Otolaryngology\u2013Head and Neck Surgery, University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James 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