The endoscopic extended transsphenoidal approach for craniopharyngiomas

Giorgio Frank, Ernesto Pasquini, Francesco Doglietto, Diego Mazzatenta, Vittorio Sciarretta, Giovanni Farneti, Fabio Calbucci

Research output: Contribution to journalArticle

201 Citations (Scopus)

Abstract

OBJECTIVE: The endoscope has recently been applied to the supradiaphragmatic transsphenoidal approach, but only case reports dealing with different pathological features have been described. The authors present their experience with this technique in 10 patients with craniopharyngiomas. METHODS: A pure endoscopic endonasal technique was used. From November 1998 through May 2005, four males and six females with a craniopharyngioma, either purely supradiaphragmatic (six patients) or with a significant suprasellar component (four patients), were treated. The tumors had a mean diameter of 2.9 cm (range, 1-4 cm); four patients had a major prechiasmatic component and six had a retrochiasmatic one. RESULTS: Seven total, one subtotal, and two partial resections were obtained. Vision symptoms improved significantly in six out of eight patients. Endocrine function did not improve after surgery, and diabetes insipidus was the most frequent deficit, although it was transient in five out of eight patients. Cerebrospinal fluid leak was the most frequent complication and required reoperation in two patients. Postoperative obesity occurred in two patients. No recurrence has yet been documented in the total resection group. The mean follow-up period is 37 months (range, 3-75 mo). CONCLUSION: The endoscopic technique allows results comparable with the best microscopic series. We think that this technique increases the safety of the procedure because of improved vision. Further studies are required to better define the exact location of the tumor with respect to the arachnoidal plane, the extra-arachnoidal craniopharyngioma being the most suitable for a radical removal using a transsphenoidal supradiaphragmatic approach.

Original languageEnglish
JournalNeurosurgery
Volume59
Issue number1 SUPPL. 1
DOIs
Publication statusPublished - Jul 2006

Fingerprint

Craniopharyngioma
Diabetes Insipidus
Endoscopes
Reoperation
Neoplasms
Obesity
Safety
Recurrence

Keywords

  • Craniopharyngioma
  • Endoscopic
  • Extended
  • Supradiaphragmatic
  • Suprasellar
  • Transsphenoidal

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Frank, G., Pasquini, E., Doglietto, F., Mazzatenta, D., Sciarretta, V., Farneti, G., & Calbucci, F. (2006). The endoscopic extended transsphenoidal approach for craniopharyngiomas. Neurosurgery, 59(1 SUPPL. 1). https://doi.org/10.1227/01.NEU.0000219897.98238.A3

The endoscopic extended transsphenoidal approach for craniopharyngiomas. / Frank, Giorgio; Pasquini, Ernesto; Doglietto, Francesco; Mazzatenta, Diego; Sciarretta, Vittorio; Farneti, Giovanni; Calbucci, Fabio.

In: Neurosurgery, Vol. 59, No. 1 SUPPL. 1, 07.2006.

Research output: Contribution to journalArticle

Frank, G, Pasquini, E, Doglietto, F, Mazzatenta, D, Sciarretta, V, Farneti, G & Calbucci, F 2006, 'The endoscopic extended transsphenoidal approach for craniopharyngiomas', Neurosurgery, vol. 59, no. 1 SUPPL. 1. https://doi.org/10.1227/01.NEU.0000219897.98238.A3
Frank, Giorgio ; Pasquini, Ernesto ; Doglietto, Francesco ; Mazzatenta, Diego ; Sciarretta, Vittorio ; Farneti, Giovanni ; Calbucci, Fabio. / The endoscopic extended transsphenoidal approach for craniopharyngiomas. In: Neurosurgery. 2006 ; Vol. 59, No. 1 SUPPL. 1.
@article{264a170f34a242aa96cf3fbbd23a4f73,
title = "The endoscopic extended transsphenoidal approach for craniopharyngiomas",
abstract = "OBJECTIVE: The endoscope has recently been applied to the supradiaphragmatic transsphenoidal approach, but only case reports dealing with different pathological features have been described. The authors present their experience with this technique in 10 patients with craniopharyngiomas. METHODS: A pure endoscopic endonasal technique was used. From November 1998 through May 2005, four males and six females with a craniopharyngioma, either purely supradiaphragmatic (six patients) or with a significant suprasellar component (four patients), were treated. The tumors had a mean diameter of 2.9 cm (range, 1-4 cm); four patients had a major prechiasmatic component and six had a retrochiasmatic one. RESULTS: Seven total, one subtotal, and two partial resections were obtained. Vision symptoms improved significantly in six out of eight patients. Endocrine function did not improve after surgery, and diabetes insipidus was the most frequent deficit, although it was transient in five out of eight patients. Cerebrospinal fluid leak was the most frequent complication and required reoperation in two patients. Postoperative obesity occurred in two patients. No recurrence has yet been documented in the total resection group. The mean follow-up period is 37 months (range, 3-75 mo). CONCLUSION: The endoscopic technique allows results comparable with the best microscopic series. We think that this technique increases the safety of the procedure because of improved vision. Further studies are required to better define the exact location of the tumor with respect to the arachnoidal plane, the extra-arachnoidal craniopharyngioma being the most suitable for a radical removal using a transsphenoidal supradiaphragmatic approach.",
keywords = "Craniopharyngioma, Endoscopic, Extended, Supradiaphragmatic, Suprasellar, Transsphenoidal",
author = "Giorgio Frank and Ernesto Pasquini and Francesco Doglietto and Diego Mazzatenta and Vittorio Sciarretta and Giovanni Farneti and Fabio Calbucci",
year = "2006",
month = "7",
doi = "10.1227/01.NEU.0000219897.98238.A3",
language = "English",
volume = "59",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "1 SUPPL. 1",

}

TY - JOUR

T1 - The endoscopic extended transsphenoidal approach for craniopharyngiomas

AU - Frank, Giorgio

AU - Pasquini, Ernesto

AU - Doglietto, Francesco

AU - Mazzatenta, Diego

AU - Sciarretta, Vittorio

AU - Farneti, Giovanni

AU - Calbucci, Fabio

PY - 2006/7

Y1 - 2006/7

N2 - OBJECTIVE: The endoscope has recently been applied to the supradiaphragmatic transsphenoidal approach, but only case reports dealing with different pathological features have been described. The authors present their experience with this technique in 10 patients with craniopharyngiomas. METHODS: A pure endoscopic endonasal technique was used. From November 1998 through May 2005, four males and six females with a craniopharyngioma, either purely supradiaphragmatic (six patients) or with a significant suprasellar component (four patients), were treated. The tumors had a mean diameter of 2.9 cm (range, 1-4 cm); four patients had a major prechiasmatic component and six had a retrochiasmatic one. RESULTS: Seven total, one subtotal, and two partial resections were obtained. Vision symptoms improved significantly in six out of eight patients. Endocrine function did not improve after surgery, and diabetes insipidus was the most frequent deficit, although it was transient in five out of eight patients. Cerebrospinal fluid leak was the most frequent complication and required reoperation in two patients. Postoperative obesity occurred in two patients. No recurrence has yet been documented in the total resection group. The mean follow-up period is 37 months (range, 3-75 mo). CONCLUSION: The endoscopic technique allows results comparable with the best microscopic series. We think that this technique increases the safety of the procedure because of improved vision. Further studies are required to better define the exact location of the tumor with respect to the arachnoidal plane, the extra-arachnoidal craniopharyngioma being the most suitable for a radical removal using a transsphenoidal supradiaphragmatic approach.

AB - OBJECTIVE: The endoscope has recently been applied to the supradiaphragmatic transsphenoidal approach, but only case reports dealing with different pathological features have been described. The authors present their experience with this technique in 10 patients with craniopharyngiomas. METHODS: A pure endoscopic endonasal technique was used. From November 1998 through May 2005, four males and six females with a craniopharyngioma, either purely supradiaphragmatic (six patients) or with a significant suprasellar component (four patients), were treated. The tumors had a mean diameter of 2.9 cm (range, 1-4 cm); four patients had a major prechiasmatic component and six had a retrochiasmatic one. RESULTS: Seven total, one subtotal, and two partial resections were obtained. Vision symptoms improved significantly in six out of eight patients. Endocrine function did not improve after surgery, and diabetes insipidus was the most frequent deficit, although it was transient in five out of eight patients. Cerebrospinal fluid leak was the most frequent complication and required reoperation in two patients. Postoperative obesity occurred in two patients. No recurrence has yet been documented in the total resection group. The mean follow-up period is 37 months (range, 3-75 mo). CONCLUSION: The endoscopic technique allows results comparable with the best microscopic series. We think that this technique increases the safety of the procedure because of improved vision. Further studies are required to better define the exact location of the tumor with respect to the arachnoidal plane, the extra-arachnoidal craniopharyngioma being the most suitable for a radical removal using a transsphenoidal supradiaphragmatic approach.

KW - Craniopharyngioma

KW - Endoscopic

KW - Extended

KW - Supradiaphragmatic

KW - Suprasellar

KW - Transsphenoidal

UR - http://www.scopus.com/inward/record.url?scp=33745798243&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745798243&partnerID=8YFLogxK

U2 - 10.1227/01.NEU.0000219897.98238.A3

DO - 10.1227/01.NEU.0000219897.98238.A3

M3 - Article

VL - 59

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 1 SUPPL. 1

ER -