Published in:
01-08-2005 | Special Annual Issue
Application of endoscopy to the surgical management of craniopharyngiomas
Published in: Child's Nervous System | Issue 8-9/2005
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Objective
The purpose of this study was to evaluate the efficacy of a minimally invasive/endoscopic approach to craniopharyngiomas (CPGs) given that the surgical aim was a complete excision of the tumor as a single stage procedure. The endoscope can be used with both a subfrontal and a transsphenoidal approach.
Methods
This study is a retrospective review of 36 operative patients who were seen by one surgeon. All patients had attempted complete excision.
Results
Patients were divided into three groups according to their preoperative status. Those in group 1 had no previous treatment and fared well, although all developed postoperative diabetes insipidus. Those in group 2 had previous surgery only and also did well with repeat surgery. Those in group 3 had been treated previously with surgery and radiotherapy and, apart from a single exception, did poorly.
Conclusion
The endoscopic, minimally invasive approach is versatile and effective in the surgical management of both first-time and repeat cases of CPG. It offers superior visualization of surrounding neurovascular structures and allows a more complete resection of tumor. It can be used for a cranial or a nasal approach to these tumors. Sadly, it failed to prevent postoperative endocrinopathy.