The combined interhemispheric subcommissural translaminaterminalis approach for large craniopharyngiomas

Pietro Mortini, Filippo Gagliardi, Nicola Boari, Fabio Roberti, Anthony J. Caputy

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We describe a variant of the interhemispheric translaminaterminalis approach for the resection of large suprasellar craniopharyngiomas. The approach is a translaminaterminalis route performed below and above the anterior communicating artery (ACoA). A cadaveric microanatomic study was conducted to describe the surgical technique. Methods: Four cadaveric specimens fixed with gluteraldehyde and injected with latex were dissected to illustrate the approach. Results: The surgical steps of the approach are reported. The ACoA anatomy was studied. In particular, the surgical route in-between and lateral to the first and second segments of the anterior cerebral artery and the ACoA complex were examined. The approach was adopted in a clinical setting; two illustrative cases regarding the removal of large craniopharyngiomas with suprasellar extension through this route are described. Conclusions: The approach with preservation of the ACoA may represent a possible route to manage large suprasellar lesions. Combination of the unilateral interhemispheric corridor with the subfrontal and the trans-sylvian routes allows for a safe and radical resection of large suprasellar craniopharyngiomas.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
JournalWorld Neurosurgery
Volume80
Issue number1-2
DOIs
Publication statusPublished - Jul 2013

Keywords

  • Anterior communicating artery
  • Craniopharyngiomas
  • Interhemispheric approach
  • Translaminaterminalis

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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