Single-Center Surgical Experience of the Treatment of Craniopharyngiomas With Emphasis on the Operative Approach: Endoscopic Endonasal and Open Microscopic Transcranial Approaches

Abstract

This study aimed to report the authors' single-center clinical experience about craniopharyngiomas and discuss surgical outcomes of these patients according to the type of surgical approach (endoscopic endonasal or open microscopic transcranial approach).Twenty-four patients diagnosed with craniopharyngiomas between May 2013 and April 2017 were considered for inclusion. The patients were divided into 2 groups according to the surgical approach (open transcranial microscopic approach [group A] and endoscopic endonasal approach [group B]). These groups were compared in terms of postoperative surgical outcome scores (extent of tumor removal, visual deficit, hydrocephalus, metabolic disorders, and Glasgow coma scale) and hospitalization interval.There was no patient of mortality in both groups. In this study, 4 of the 13 patients in group A and 9 of the 11 patients in group B underwent gross total resection. However, 1 patient in group B underwent repair because of cerebrospinal fluid leakage postoperatively. In addition, 1 patient in group A had a wound healing problem postoperatively. The postoperative outcome scores were 9.5 in group A and 11.5 in group B. The hospitalization interval in group A (range, 7-9 days) was longer than that in group B (range, 5-7 days).The endoscopic endonasal approach should be considered the first-line surgical treatment modality in patients with a preliminary diagnosis of craniopharyngioma in terms of low complication risk, minimal invasiveness, and better outcome scores. Open microscopic transcranial procedures may be combined with this approach in a single session for challenging cases.

Quality of life and olfactory function after suprasellar craniopharyngioma surgery—a single-center experience comparing transcranial and endoscopic endonasal approaches

“…However, this makes no sense in such small group sizes. Nevertheless, craniopharyngiomas are a rather rare disease and most series have a magnitude of size like we present in our study [7,22,25,33]. A solution for this problem would be a large multicenter study, as was done by Little et al with regard to the comparison of endoscopic versus microsurgical endonasal approaches to pituitary lesions [18].…”

“…All axes in this group experienced a significant deterioration, whereas in the endonasal resection group the differences reached only in part statistical significance. Most studies are not addressing the single anterior pituitary lobe hormone axes, but rather make statements like “total” or “partial” anterior pituitary lobe deficiency [ 14 , 16 , 22 , 25 , 33 ]. Thus, their results are not comparable to our single-axis analysis.…”

Non-Invasive Radiomics Approach Predict Invasiveness of Adamantinomatous Craniopharyngioma Before Surgery

“…Although the history of surgical treatment for CPs has been spanned the course of more than 100 years, these masses still pose a surgical challenge even after the application of modern neurosurgical techniques ( 18 – 22 ). Numerous studies have revealed that quality of life (QoL) and cognitive performance are frequently impaired in long-term survivors after surgery due to the anatomical proximity of the CPs to the optic nerve and to the hypothalamic-pituitary axes ( 23 – 25 ).…”

Pituitary hormonal status after endoscopic endonasal transphenoidal removal of nonfunctioning pituitary adenoma: 5 years' experience in a single center

“…Endoscopic transphenoidal surgery is one of those less invasive surgical techniques that allow patients with sellar tumors, especially the pituitary tumor, to recover and return to their daily life faster when comparing to conventional open craniotomy surgery. [ 4 5 6 ] Nevertheless, the endoscopic transphenoidal surgery to remove pituitary tumor may result in the higher chance of complications from pituitary hormone disorders because of pituitary gland and stalk manipulation during the operation.…”