Enhancing access to the suprasellar region: the transcallosal translamina terminalis approach

Guillermo Aldave MD, PhD
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  • Division of Pediatric Neurosurgery, Department of Surgery, Texas Children’s Hospital; and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
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Craniopharyngioma represents one of the most challenging brain tumors to treat. Surgery may be the definitive treatment, and multiple surgical approaches have been described, each based on different anatomical considerations. Some approaches require working through narrow corridors that do not often provide a sufficient view of the critical anatomical structures around the tumor. The choice of the right approach is key for optimizing resection and minimizing risk. In this paper, the author presents the case of a pediatric patient with a large suprasellar craniopharyngioma who underwent complete resection of the tumor through a novel approach: a transcallosal translamina terminalis corridor. This particular transcallosal corridor, behind the anterior communicating artery, allows the optimal opening of the lamina terminalis extending up to the anterior commissure. This novel variation of the traditional operation provides a wider exposure of the tumor compared with the classic approaches through the lamina terminalis. This technique has not been sufficiently described in the pediatric literature. The author describes it here as an alternative method for treating patients with sellar and suprasellar tumors.

ABBREVIATIONS ACA = anterior cerebral artery; AComA = anterior communicating artery; CC = corpus callosum.

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Contributor Notes

Correspondence Guillermo Aldave: Texas Children’s Hospital, Houston, TX. gxaldave@texaschildrens.org.

INCLUDE WHEN CITING Published online August 28, 2020; DOI: 10.3171/2020.5.PEDS20369.

Disclosures The author reports no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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