Image- guided extended endoscopic endonasal transsphenoidal approach for removal of cranio- pharyngiomas in the suprasellar region and third ventricle

Abstract

Objective To investigate the feasibility and efficacy of image -guided extended endoscopic endonasal transsphenoidal approach（EEETA） for the removal of craniopharyngiomas in the suprasellar region and third ventricle. Method A pure EEETA with image -guided system was used. Three patients with a craniopharyngioma involving the suprasellar region and third ventricle were treated. Results Total craniopharyngioma removal was achieved in three cases. All the patients recovered uneventfully. The follow - up study was carried out for 10 to 14 months with good outcomes. Compensatory endocrine substitution therapy was needed in all of them. Conclusions The EEETA for removal of craniopharyngiomas in the suprasellar region and third ventricle is feasible and effective. It has the advantages of no needing for brain retraction,offering panoramic view of retrochiasmatic and infrachiasmatic regions,manipulating under direct vision and protecting hypothalamus,pituitary stalk and other vital structures. The EEETA is a novel and minimally invasive approach for selected cases of craniopharyngioma. Neuronavigation plays an important role in identifying anatomic landmarks,guiding surgical direction and increasing safety of the operations. Key words: Neuronavigation ; Endoscopes ; Extended endonasal transsphenoidal approach ; Craniopharyngioma; Suprasellar region ; Third ventricle