Experience in the diagnosis and treatment of the postoperative complications of craniopharyngiomas through expanded endoscopic endonasal transsphenoidal approach

Abstract

Objective:To summarize the clinical characteristics of the postoperative complications of surgical resection of craniopharyngiomas through expanded endoscopic endonasal transsphenoidal approach （EEETA）. Strategies for prevention and management were also discussed. Methods:The clinical data of the patients who were treated through EEETA were retrospectively reviewed. The occurrence of post-operative complications were recorded. Results:Partial removal of the tumors were accomplished in 11 cases and subtotal removal in 4 cases. The major postoperative complications were anterior pituitary hypofunction（11/15）, diabetes insipidus（8/15）, epistaxis（3/15）, cerebrospinal fluid rhinorrhea（1/15）. The cases were treated symptomatically or by re-operation. Of all the cases,10 patients were improved,1 patient had drowsiness,3 suffered from multiple organ failure，and 1 patient died. Conclusion:To prevent and reduce the postoperative complications of EEETA, first of all, it is essential to evaluate the need for surgical intervention and perform a comprehensive preoperative assessment. Critical nerves and vessels should be preserved carefully during operation for the sake of avoiding injuries normal pituitary and hypothalamus. Furthermore, reconstruction of the skull base is critical. The standard procedure of nasal endoscopy and the experience of the surgeons are quite significant, while the operation needs multidisciplinary collaborations.