Advances in the management of craniopharyngioma

O’steen, Lillie; Indelicato, Daniel J.

doi:10.12688/f1000research.15834.1

Cited by 35 publications

(23 citation statements)

References 21 publications

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“…Although the management of craniopharyngioma remains somewhat controversial, numerous studies have demonstrated that, STR with adjuvant radiotherapy has similar therapeutic value as GTR. [18][19][20] After all, if safe resection is possible, GTR as the initial treatment should be attempted to reduce the tumor recurrence. However, if the tumor recurs after the first surgery, radiotherapy or gamma knife radiosurgery with/ without reoperation may be an effective salvage treatment for recurrent craniopharyngioma.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Endoscopic Endonasal Surgery in 29 Patients with Craniopharyngioma

Iranmehr

Esmaeilnia

Afshari

et al. 2020

J Neurol Surg B Skull Base

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Background Recently the endoscopic endonasal surgery (EES) has been introduced as a modality for the treatment of patients with craniopharyngiomas. In this study, we describe our initial experience in treatment of 29 patients with craniopharyngiomas using this approach. Methods Twenty-nine consecutive patients with craniopharyngiomas who had undergone EES in a 5-year period were studied retrospectively. Patients underwent preoperative and postoperative endocrinologic and ophthalmologic evaluations. Radiologic characteristics of tumors and extent of resection were determined. The recurrence and complications were evaluated. Results Pituitary and visual dysfunction were observed preoperatively in 89.7 and 86% of patients, respectively. After EES, visual outcome either showed an improvement or else remained unchanged in 92.3% of the cases; however, pituitary function remained unchanged and even got worsened in 34.6% of the cases. Prevalence of diabetes insipidus before and after surgery was 58.6 and 69.2%. The rate of gross total resection was 62%. Moreover, 86.2% of the tumors were almost totally resected (more than 95% of the tumor size resected). After surgery, cerebrospinal fluid (CSF) leak and meningitis occurred in four (13.8%) and two (6.9%) patients, respectively. Perioperative mortality was seen in two of the cases (6.9%). The mean follow-up was 25 months and tumor recurrence was discovered in four patients (15.3%). Conclusion The EES with the goal of maximal and safe tumor resection could be used for the treatment of most craniopharyngiomas. Although the rates of visual improvement and gross tumor resection are high, CSF leak, pituitary dysfunction, and meningitis are serious concerns.

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Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Endoscopic Endonasal Surgery in 29 Patients with Craniopharyngioma

Iranmehr

Esmaeilnia

Afshari

et al. 2020

J Neurol Surg B Skull Base

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“…In patients that underwent STR postoperative external beam radiotherapy (RT) is presently standard of care to achieve an optimal progression-free survival 13,41, 42, 43, 44. In most studies, attention has been paid to radiation fibrosis syndrome while the impact of RT on QoL has been studied to a much lesser extent.…”

Section: Imaging and Treatmentmentioning

confidence: 99%

Advances in the management of craniopharyngioma in children and adults

Jensterle

Jazbinšek

Bošnjak

et al. 2019

Radiology and Oncology

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BackgroundChildhood and adult-onset craniopharyngioma is a rare embryogenic tumor of the sellar, suprasellar, and parasellar region. Survival rates are high; however, tumor location and treatment sequalae including endocrine deficits, visual impairment, metabolic complications, cognitive and psychosocial deficits can significantly impair patient’s quality of life. There is considerable controversy regarding the optimal management of craniopharyngiomas. Subtotal resection of the tumor followed by targeted irradiation to avoid further hypothalamic damage is currently indicated. Novel insights in the tumor’s molecular pathology present the possibility for targeted therapy possibly decreasing the rate and severity of treatment-associated morbidity.ConclusionsCraniopharyngioma should be seen as a chronic disease. To achieve optimal outcomes a multidisciplinary team of specialized neurosurgeons, neuro-radiologists, neuro-oncologists, pathologists and endocrinologists should be involved in the diagnosis, planning of the surgery, irradiation and long-term follow-up.

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“…With the emergence of endoscopic endonasal surgery (EES), suprasellar and select intraventricular tumors that were only accessible by craniotomy can now be resected by endoscopic endonasal surgery, often with better clinical results relative to transcranial resection. 3 Compared to transcranial methods managed by nasoseptal flaps and multilayer repair, CSF leak is the most pronounced drawback of endoscopic endonasal surgery. 4 To avoid local recurrence, radiotherapy is also advised for residual or recurrent craniopharyngioma following surgical resection.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Almelesy

2021

Al-Azhar International Medical Journal

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Background: Craniopharyngiomas are challenging tumors that occur in the sellar or suprasellar regions most frequently. The endoscopic endonasal transsphenoidal approach is a minimal-invasive technique for managing craniopharyngiomas. Aim of the study: is to evaluate of endoscopic endonasal transsphenoidal approach in management of craniopharyngioma as regard the indications, operative difficulties, post-operative complications and outcomes. Patients and Methods: An analytical prospective study conducted on 12 Craniopharyngioma patients treated via endoscopic endonasal, transsphenoid approach in Al Azhar university hospitals. Follow up of patients done clinically and radiologically over 6 months. Results: The study included 12 patients, 2 (16.7%) males and 10 (83.3%) females, with mean age of 40 years. In 9 patients (75%), gross total resection was achieved. The most popular surgical complications in our series were DI (50%), CSF rhinorrhea (33.3%) and DCL and seizures (16.7%) respectively. None of our patients suffered from worsening of endocrinological or visual outcome postoperatively. Conclusion: The combination of IPACK block with ACB has the potential of being an adequate technique for management of acute postoperative pain after TKA but this needs more researches of larger samples and use of other types of local anesthetics with different volumes and concentrations.

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Advances in the management of craniopharyngioma

Cited by 35 publications

References 21 publications

Surgical Outcomes of Endoscopic Endonasal Surgery in 29 Patients with Craniopharyngioma

Surgical Outcomes of Endoscopic Endonasal Surgery in 29 Patients with Craniopharyngioma

Advances in the management of craniopharyngioma in children and adults

Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

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