Extended Endoscopic Endonasal Approach to Suprasellar Craniopharyngiomas: Results in 10 Cases

Abstract

Suprasellar craniopharyngiomas are usually approached by a transcranial route, and the transsphenoidal approach is usually employed in cases of purely sellar involvement. After extensive experience with pituitary adenomas (more than 400 endoscopic operations since 1998), the authors, since 2005, have adopted the endoscopic extended transsphenoidal approach even in cases of purely suprasellar tumors, using the 4 hands binostril technique described by Kassam. The surgical team was formed by a neurosurgeon and an ENT surgeon in every case. All the tumors had solid and cystic components and impinged on the third ventricle. Preoperatively, all the patients showed a variable degree of hypopituitarism; 5 had a visual and/or visual field defect. Zero-degree angled optics were used during the approach.