The evolution of the endonasal approach for craniopharyngiomas

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✓Craniopharyngiomas have always been an extremely challenging type of tumor to treat. The transsphenoidal route has been used for resection of these lesions since its introduction. The authors present a historical review of the literature from the introduction of the endonasal route for resection of craniopharyngiomas until the present. Abandoned early due to technological limitations, this approach has been expanded both in its application and in its anatomical boundaries with subsequent progressive improvements in outcomes. This expansion has coincided with advances in visualization devices, imaging guidance techniques, and anatomical understanding. The progression from the use of headlights, to microscopy, to endoscopy and fluoroscopy, and finally to modern intraoperative magnetic resonance–guided techniques, combined with collaboration between otolaryngologists and neurosurgeons, has provided the framework for the development of current techniques for the resection of sellar and suprasellar craniopharyngiomas.

Abbreviation used in this paper: CSF = cerebrospinal fluid.
Article Information

Contributor Notes

Address correspondence to: Amin Kassam, M.D., Department of Neurological Surgery, Suite B-400, Presbyterian University Hospital, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213. email: kassamab@upmc.edu.
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