Craniopharyngeal Canal and Its Spectrum of Pathology

Abstract

BACKGROUND AND PURPOSE:The craniopharyngeal canal is a rare, well-corticated defect through the midline of the sphenoid bone from the sellar floor to the anterosuperior nasopharyngeal roof. We reviewed a series of craniopharyngeal canals to determine a system of classification that might better our understanding of this entity, highlight the range of associated pathologic conditions, and optimize patient treatment.

Chiari type 1 malformation, corpus callosum agenesis and patent craniopharyngeal canal in an 11-year-old boy

“…10 Small incidental canals are found to be benign in most cases, but especially the larger craniopharyngeal canals may be associated with other craniofacial abnormalities such as holoprosencephaly, cleft lip and palate, orbital hypoplasia and agenesis of the corpus callosum. 9,11,12 Although there are several disagreements regarding the development of the pituitary gland and the timing of the closure of the craniopharyngeal canal, the combined presence with the corpus callosum agenesis could suggest an embryological event around the 13th-14th week of gestation in this case. 13 Sener described the association of Chiari type 1, callosal dysgenesis and ectopic neurohypophysis.…”

Craniopharyngeal duct: a cause of recurrent meningitis

“…2,4 Around the fifth to sixth week, the pouch elongates further, forming an elongated stalk between the pouch and the stomatodeum The cartilaginous skull base forms at around the sixth to seventh week of gestation, obliterating the adenohypophyseal stalk. 4 Incomplete fusion of the cartilaginous elements results in incomplete obliteration of the adenohypohyseal stalk, which persists as the craniopharyngeal duct or canal, extending from the sella turcica to the nasopharynx. 2,4,5 Some authors have proposed that the craniopharyngeal duct represents a vascular channel.…”

“…6 Currarino et al 7 classified the abnormality on the basis of size: the hypophyseal channel or the small craniopharyngeal canal, which have a maximum width of 15 mm, and the large craniopharyngeal canal or transspehnoidal channel, which are more commonly associated with other craniofacial abnormalities such as encephalocoeles, cleft palate and lips and such. More recently, a classification of the craniopharyngeal duct has been proposed by Abele et al 4 based on the size and spectrum of other associated pathologies (e.g. pituitary adenomas, craniophahryngiomas, teratomas and gliomas).…”

Ectopic Occurrence of Craniopharyngiomas

“…A second theory considers craniopharyngiomas to be derived from metaplastic transformation of differentiated squamous epithelium, which is part of the anterior lobe of the pituitary (Larkin and Ansorge, 2012). An argument in favor of the embryogenetic theory is the fact that there is a spectrum of disease associated with the development of Rathke's pouch in which a persistent craniopharyngeal canal (Abele, 2013) can be associated with different pathological entities, amongst them craniopharyngioma.…”