Surgical treatment of chiasmal-sellar region formations is a difficult task of modern neurosurgery. A neurosurgeon has to choose between the invasive nature of a surgery and possible post-surgery complications. This situation most often occurs in the chiasmal-sellar cysts, such as Rathke’s cleft cysts, colloidal cysts of the chiasmal-sellar region, epidermoid cysts of the chiasmal-sellar region, dermoid cysts of the chiasmal-sellar region and arachnoid cysts of the chiasmal-sellar region. Even though surgical procedures designed to reduce the relapses and to mitigate the risk of post-surgical complications were described for these disorders, many complications are mentioned by some authors when they use the same treatment method, despite the positive results achieved by others. Thus, the choice of the surgical approach to patients with chiasmal-sellar cysts remains relevant.
The diagnosis of chiasmal-sellar cysts does not lose its relevance either. This is largely due to the lack of accurate differential diagnosis of chiasmal-sellar formations based on the disease clinical signs. In addition, sometimes any chiasmal-sellar formation is described by a radiologist as pituitary adenoma [1], which is most likely due to the fact that pituitary adenoma is the most common chiasmal-sellar pathology. However, as described above, each type of chiasmal-sellar cysts has its own peculiarities of surgical treatment, which enables to minimize relapses and to reduce complications [2–5]. Thus, an incorrect diagnosis may lead to several intraoperative problems and, as a result, deterioration of medical care.
With chiasmal-sellar cysts being a rare disorder, neurologists and neurosurgeons have little experience with them. The development of a treatment and diagnostic algorithm for chiasmal-sellar cysts would allow an accurate differential diagnosis, on the basis of which a specialist, using the developed algorithm, would be able to determine further treatment approach and, if necessary, the surgery features in advance.