Feasibility of endoscopic endonasal resection of intrinsic third ventricular craniopharyngioma in adults

Cao, Lei; Wu, Wentao; Kang, Jie; Cai, Kefan; Li, Chuzhong; Liu, Chunhui; Zhu, Haibo; Gen, Suming; Zhang, Yazhou; Gui, Songbai

doi:10.1007/s10143-022-01807-2

Cited by 7 publications

(7 citation statements)

References 32 publications

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“…This pathological and topographical information is invaluable information for a neurosurgeon when planning surgical resection or targeted therapy [115]. This claim is further evidenced by recent demonstrations of total resection of the CP subtype, illustrating the use these findings [40,116].…”

Section: Topographical Variantsmentioning

confidence: 80%

“…Regarding par tuberalis CPs, endonasal procedures were associated with longer operative durations, higher gross-total resections, and decreased recurrence rates [39]. Cao et al [40] analyzes 22 cases to determine such efficacy with the following observations: gross total resection was attained in over 95% of the cases (n = 21), with 68% (n = 15) developing new onset endocrinological deficits. Barring these complications, the endonasal approach is suggested to perhaps be useful for resection of IVCs without significant morbidities or lethality [40].…”

Section: Standard and Extended Transsphenoidal Approachesmentioning

confidence: 99%

“…[ 40 ] analyzes 22 cases to determine such efficacy with the following observations: gross total resection was attained in over 95% of the cases (n = 21), with 68% (n = 15) developing new onset endocrinological deficits. Barring these complications, the endonasal approach is suggested to perhaps be useful for resection of IVCs without significant morbidities or lethality [ 40 ]. In a similar vein, Kassam and colleagues [ 41 ] also touch on the heterogenous considerations CPs demand based on the regional locations of their parasellar extensions.…”

Section: Theories Of Developmentmentioning

confidence: 99%

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Current Approaches to Craniopharyngioma Management

Diaz¹,

Kwak²,

Root³

et al. 2022

Front. Biosci. (Landmark Ed)

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Craniopharyngiomas (CP) are rare noncancerous brain tumors located in the skull base. To date, CP remain challenging-to-resect tumors, owing to their difficult location and invasive potential, with profound adverse effects for the patient if left to grow. Indeed, gross total resection may also be accompanied by unwelcome sequalae, underscoring the need for continued investigation. In the present work, we provide a scoping review of current CP management, with emphasis on our knowledge of their genesis, available treatment options, post-intervention clinical outcomes. Leading theories of CP development are (1) the embryonic theory, explaining the development of adamantinomatous CP from epithelial remnants of Rathke's pouch and (2) the metaplastic theory, which describes papillary CP development as a result of adenohypophyseal cell metaplasia. Treatment may include surgery, intracystic therapy, or irradiation depending on tumor size, history and location. However, whether a single ideal approach and timing for CP intervention exists remains debated. We appraise and critique these areas with priority for emerging basic results and innovation.

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Section: Topographical Variantsmentioning

confidence: 80%

Section: Standard and Extended Transsphenoidal Approachesmentioning

confidence: 99%

Section: Theories Of Developmentmentioning

confidence: 99%

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Current Approaches to Craniopharyngioma Management

Diaz¹,

Kwak²,

Root³

et al. 2022

Front. Biosci. (Landmark Ed)

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“…Concurrently, if the tumor exceeded 10% of the infra-NCL region, both TLTA and TCPC techniques were employed. The step-by-step details of the surgical procedures can be found in previous publications [17][18][19]. An intraoperative visual evoked potential (VEP) was used to monitor visual function [20].…”

Section: Surgical Planning and Techniquesmentioning

confidence: 99%

A Full View of Papillary Craniopharyngioma Based on Expanded Endonasal Approach: A Comprehensive Clinical Characterization of 101 Cases

Jia,

Cai,

Qiao

et al. 2023

JCM

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Objective: The enlarged endonasal approach (EEA) has emerged as the preferred surgical procedure for removing craniopharyngiomas, due to its advantages of direct visualization and reduction of blind corners. However, owing to a low incidence of papillary CPs (PCPs) compared to adamantinomatous CPs (ACPs), a full view of PCP based on the EEA approach is limited. In this paper, the authors present the largest series to date analyzing the clinical characteristics based on the EEA approach for PCPs. Methods: A retrospective review was conducted on 101 PCPs patients who underwent endoscopic endonasal surgery (EEA) and whose condition was confirmed via postoperative pathology. The PCPs were classified into three types based on MRI data and intraoperative findings from EEA: suprasellar/intra-suprasellar (3V floor intact) type (Type I), suprasellar/intra-suprasellar (3V floor invasive) type (Type II), and intra-third ventricle type (Type III). The general characteristics of the three types of tumors were summarized, and postoperative follow-up was conducted to record detailed information on changes in vision, endocrine replacement, tumor recurrence, and quality of life. Results: Out of the 101 cases, 36 (36.64%) were classified as type I, 52 (51.49%) as type II, and 13 (12.87%) as type III. The mean age of type III patients was 40.46 ± 14.15 years old, younger than the other two types (p = 0.021). Headache (84.62%) and memory decline (61.54%) were prominent features in patients with type III (p = 0.029). Visual impairment was more common in type II (80.77%, p = 0.01). Gross total resection (GTR) was achieved in 91 patients (90.10%). There were no significant differences in GTR rates among the three types of tumors. There were significant differences in quality of life among the three types of PCP (p = 0.004), and type III presented with the highest rate of good postoperative quality of life (92.31%) based on the KPS score. Thirteen (12.87%) tumors recurred within a mean follow-up time of 38 (range, 8–63) months. Type II PCPs (OR 5.826, 95%CI 1.185–28.652, p = 0.030) and relapsed patients (OR 4.485, 95%CI 1.229–16.374, p = 0.023) were confirmed as independent risk factors for tumor recurrence. Conclusions: Most of the PCPs including intra-third ventricle PCPs can be safely and effectively removed through neuroendoscopy with EEA. Suprasellar/intra-suprasellar (third cerebral ventricle floor-invasive) type PCPs may have a worse postoperative quality of life compared to the other two types, and it may be a strong predictor of tumor recurrence.

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“…For tumors that are purely intraventricular, TCA is often preferred to EEA [44]. For these tumors, an infrachiasmatic corridor is used to dissect the tumor, with additional use of the suprachiasmatic corridor or the suprachiasmatic trans-lamina terminalis corridor if the infrachiasmatic corridor is too narrow [47]. For these extended approaches, intraoperative visual evoked potential can be utilized to prevent injury to the optic nerve and resultant visual impairment [48].…”

Section: Surgical Managementmentioning

confidence: 99%

Craniopharyngioma surgery for rhinologists

Salmon

Kshirsagar

Eide

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewCraniopharyngiomas are rare tumors that that present with loss of pituitary function in most cases. They present in a bimodal age distribution and the most common treatment paradigms include gross total resection or subtotal resection followed by radiation. Endoscopic transnasal access to intradural tumors has become increasingly common due to improvements in equipment, increased familiarity with the surgical corridor and anatomy, and reconstruction techniques. As such, rhinologists play an increasingly important role in the management of craniopharyngiomas. Recent findingsRecent years have highlighted our growing experience with pediatric endonasal skull base surgery. Prior concerns including sphenoid pneumatization, midfacial growth restrictions, and intercarotid space limitations have been studied more extensively. It has been found that there are no increased complications with lack of sphenoid pneumatization, no changes to midfacial growth with endonasal techniques, and the inter-carotid distance is stable after around age 5. Advances in surgical and skull base reconstruction techniques and intraoperative monitoring have reduced the risks of complications from surgery. SummaryRhinologists play an important role in craniopharyngioma surgery. The approach to and reconstruction after tumor removal are vital portions of the procedure that allow for resection and prevent postsurgical complications.

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Feasibility of endoscopic endonasal resection of intrinsic third ventricular craniopharyngioma in adults

Cited by 7 publications

References 32 publications

Current Approaches to Craniopharyngioma Management

Current Approaches to Craniopharyngioma Management

A Full View of Papillary Craniopharyngioma Based on Expanded Endonasal Approach: A Comprehensive Clinical Characterization of 101 Cases

Craniopharyngioma surgery for rhinologists

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