The endoscopic endonasal approach for the management of craniopharyngiomas: a series of 103 patients

Clinical article

View More View Less
  • 1 Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples;
  • 2 Center for Pituitary Tumors and Endoscopic Skull Base Surgery, Bellaria Hospital, Neurosurgical Department, IRCCS Istituto delle Scienze Neurologiche, Bologna;
  • 3 Department of Economic Sciences, Università degli Studi di Cassino; and
  • 4 Department of Neurosciences, Division of Neurosurgery, Università degli Studi di Messina, Italy
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Object

Despite their benign histological appearance, craniopharyngiomas can be considered a challenge for the neurosurgeon and a possible source of poor prognosis for the patient. With the widespread use of the endoscope in endonasal surgery, this route has been proposed over the past decade as an alternative technique for the removal of craniopharyngiomas.

Methods

The authors retrospectively analyzed data from a series of 103 patients who underwent the endoscopic endonasal approach at two institutions (Division of Neurosurgery of the Università degli Studi di Napoli Federico II, Naples, Italy, and Division of Neurosurgery of the Bellaria Hospital, Bologna, Italy), between January 1997 and December 2012, for the removal of infra- and/or supradiaphragmatic craniopharyngiomas. Twenty-nine patients (28.2%) had previously been surgically treated.

Results

The authors achieved overall gross-total removal in 68.9% of the cases: 78.9% in purely infradiaphragmatic lesions and 66.3% in lesions involving the supradiaphragmatic space. Among lesions previously treated surgically, the gross-total removal rate was 62.1%. The overall improvement rate in visual disturbances was 74.7%, whereas worsening occurred in 2.5%. No new postoperative defect was noted. Worsening of the anterior pituitary function was reported in 46.2% of patients overall, and there were 38 new cases (48.1% of 79) of postoperative diabetes insipidus. The most common complication was postoperative CSF leakage; the overall rate was 14.6%, and it diminished to 4% in the last 25 procedures, thanks to improvement in reconstruction techniques. The mortality rate was 1.9%, with a mean follow-up duration of 48 months (range 3–246 months).

Conclusions

The endoscopic endonasal approach has become a valid surgical technique for the management of craniopharyngiomas. It provides an excellent corridor to infra- and supradiaphragmatic midline craniopharyngiomas, including the management of lesions extending into the third ventricle chamber. Even though indications for this approach are rigorously lesion based, the data in this study confirm its effectiveness in a large patient series.

Abbreviations used in this paper:DI = diabetes insipidus; GTR = gross-total resection; PR = partial removal; QOL = quality of life; STR = subtotal resection.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address correspondence to: Domenico Solari, M.D., Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy. email: domenico.solari@unina.it.

Please include this information when citing this paper: published online May 2, 2014; DOI: 10.3171/2014.3.JNS131521.

  • 1

    Ali ZS, , Lang SS, , Kamat AR, , Adappa ND, , Palmer JN, & Storm PB, : Suprasellar pediatric craniopharyngioma resection via endonasal endoscopic approach. Childs Nerv Syst 29:20652070, 2013

    • Search Google Scholar
    • Export Citation
  • 2

    Backlund EO: Treatment of craniopharyngiomas: the multimodality approach. Pediatr Neurosurg 21:Suppl 1 8289, 1994

  • 3

    Backlund EO, , Axelsson B, , Bergstrand CG, , Eriksson AL, , Norén G, & Ribbesjö E, : Treatment of craniopharyngiomas—the stereotactic approach in a ten to twenty-three years' perspective. I. Surgical, radiological and ophthalmological aspects. Acta Neurochir (Wien) 99:1119, 1989

    • Search Google Scholar
    • Export Citation
  • 4

    Baskin DS, & Wilson CB: Surgical management of craniopharyngiomas. A review of 74 cases. J Neurosurg 65:2227, 1986

  • 5

    Bunin GR, , Surawicz TS, , Witman PA, , Preston-Martin S, , Davis F, & Bruner JM: The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547551, 1998

    • Search Google Scholar
    • Export Citation
  • 6

    Caldarelli M, , di Rocco C, , Papacci F, & Colosimo C Jr: Management of recurrent craniopharyngioma. Acta Neurochir (Wien) 140:447454, 1998

    • Search Google Scholar
    • Export Citation
  • 7

    Campbell PG, , McGettigan B, , Luginbuhl A, , Yadla S, , Rosen M, & Evans JJ: Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas. Neurosurg Focus 28:4 E8, 2010

    • Search Google Scholar
    • Export Citation
  • 8

    Cappabianca P, , Cavallo LM, , Esposito F, , de Divitiis O, , Messina A, & de Divitiis E, Extended endoscopic endonasal approach to the midline skull base: the evolving role of transsphenoidal surgery. Pickard JD, , Akalan N, & Di Rocco C, : Advances and Technical Standards in Neurosurgery 33:New York, Springer, 2008. 151199

    • Search Google Scholar
    • Export Citation
  • 9

    Carmel P, Craniopharyngioma: transcranial approaches. Apuzzo ML: Brain Surgery: Complication Avoidance and Management New York, Churchill Livingstone, 1993. 1:339356

    • Search Google Scholar
    • Export Citation
  • 10

    Cavallo LM, , de Divitiis O, , Aydin S, , Messina A, , Esposito F, & Iaconetta G, : Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: anatomic considerations—part 1. Neurosurgery 61:3 Suppl 2434, 2007

    • Search Google Scholar
    • Export Citation
  • 11

    Cavallo LM, & Esposito F: Endoscopic anterior approaches and the cerebrospinal fluid (CSF) leak effect: change one thing, change everything. World Neurosurg 74:566567, 2010

    • Search Google Scholar
    • Export Citation
  • 12

    Cavallo LM, , Messina A, , Cappabianca P, , Esposito F, , de Divitiis E, & Gardner P, : Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations. Neurosurg Focus 19:1 E2, 2005

    • Search Google Scholar
    • Export Citation
  • 13

    Cavallo LM, , Messina A, , Esposito F, , de Divitiis O, , Dal Fabbro M, & de Divitiis E, : Skull base reconstruction in the extended endoscopic transsphenoidal approach for suprasellar lesions. J Neurosurg 107:713720, 2007

    • Search Google Scholar
    • Export Citation
  • 14

    Cavallo LM, , Prevedello DM, , Solari D, , Gardner PA, , Esposito F, & Snyderman CH, : Extended endoscopic endonasal transsphenoidal approach for residual or recurrent craniopharyngiomas. Clinical article. J Neurosurg 111:578589, 2009

    • Search Google Scholar
    • Export Citation
  • 15

    Cavallo LM, , Solari D, , Esposito F, & Cappabianca P: The endoscopic endonasal approach for the management of craniopharyngiomas involving the third ventricle. Neurosurg Rev 36:2738, 2013

    • Search Google Scholar
    • Export Citation
  • 16

    Ciric IS, & Cozzens JW: Craniopharyngiomas: transsphenoidal method of approach—for the virtuoso only?. Clin Neurosurg 27:169187, 1980

    • Search Google Scholar
    • Export Citation
  • 17

    Cohen M, , Bartels U, , Branson H, , Kulkarni AV, & Hamilton J: Trends in treatment and outcomes of pediatric craniopharyngioma, 1975–2011. Neuro Oncol 15:767774, 2013

    • Search Google Scholar
    • Export Citation
  • 18

    Couldwell WT, , Weiss MH, , Rabb C, , Liu JK, , Apfelbaum RI, & Fukushima T: Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery 55:539550, 2004

    • Search Google Scholar
    • Export Citation
  • 19

    de Divitiis E, , Cappabianca P, & Cavallo LM: Endoscopic transsphenoidal approach: adaptability of the procedure to different sellar lesions. Neurosurgery 51:699707, 2002

    • Search Google Scholar
    • Export Citation
  • 20

    de Divitiis E, , Cappabianca P, , Cavallo LM, , Esposito F, , de Divitiis O, & Messina A: Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas. Neurosurgery 61:5 Suppl 2 219228, 2007

    • Search Google Scholar
    • Export Citation
  • 21

    de Divitiis E, , Cavallo LM, , Cappabianca P, & Esposito F: Extended endoscopic endonasal transsphenoidal approach for the removal of suprasellar tumors: Part 2. Neurosurgery 60:4659, 2007

    • Search Google Scholar
    • Export Citation
  • 22

    De Vile CJ, Craniopharyngioma. Wass JA, & Shalet SM: Oxford Textbook of Endocrinology and Diabetes Oxford, Oxford University Press, 2002. 218225

    • Search Google Scholar
    • Export Citation
  • 23

    De Vile CJ, , Grant DB, , Kendall BE, , Neville BG, , Stanhope R, & Watkins KE, : Management of childhood craniopharyngioma: can the morbidity of radical surgery be predicted?. J Neurosurg 85:7381, 1996

    • Search Google Scholar
    • Export Citation
  • 24

    Dehdashti AR, , Ganna A, , Witterick I, & Gentili F: Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations. Neurosurgery 64:677689, 2009

    • Search Google Scholar
    • Export Citation
  • 25

    Duff JM, , Meyer FB, , Ilstrup DM, , Laws ER Jr, , Schleck CD, & Scheithauer BW: Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46:291305, 2000

    • Search Google Scholar
    • Export Citation
  • 26

    Esposito F, , Dusick JR, , Fatemi N, & Kelly DF: Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery. Neurosurgery 60:4 Suppl 2 295304, 2007

    • Search Google Scholar
    • Export Citation
  • 27

    Fahlbusch R, , Honegger J, & Buchfelder M, Clinical features and management of craniopharyngiomas in adults. Tindall GT, , Cooper PR, & Barrow DL: The Practice of Neurosurgery Baltimore, Williams & Wilkins, 1996. 11591173

    • Search Google Scholar
    • Export Citation
  • 28

    Fahlbusch R, , Honneger J, & Buchfelder M, Transsphenoidal microsurgery for craniopharyngiomas. Schmidek HH: Operative Neurosurgical Techniques: Indications, Methods, and Results ed 4 Philadelphia, WB Saunders, 2000. 1:503511

    • Search Google Scholar
    • Export Citation
  • 29

    Fahlbusch R, , Honegger J, , Paulus W, , Huk W, & Buchfelder M: Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90:237250, 1999

    • Search Google Scholar
    • Export Citation
  • 30

    Fischer EG, , Welch K, , Shillito J Jr, , Winston KR, & Tarbell NJ: Craniopharyngiomas in children. Long-term effects of conservative surgical procedures combined with radiation therapy. J Neurosurg 73:534540, 1990

    • Search Google Scholar
    • Export Citation
  • 31

    Fortes FS, , Carrau RL, , Snyderman CH, , Prevedello D, , Vescan A, & Mintz A, : The posterior pedicle inferior turbinate flap: a new vascularized flap for skull base reconstruction. Laryngoscope 117:13291332, 2007

    • Search Google Scholar
    • Export Citation
  • 32

    Frank G, , Pasquini E, , Doglietto F, , Mazzatenta D, , Sciarretta V, & Farneti G, : The endoscopic extended transsphenoidal approach for craniopharyngiomas. Neurosurgery 59:1 Suppl 1 ONS75ONS83, 2006

    • Search Google Scholar
    • Export Citation
  • 33

    Gardner PA, , Kassam AB, , Snyderman CH, , Carrau RL, , Mintz AH, & Grahovac S, : Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series. J Neurosurg 109:616, 2008

    • Search Google Scholar
    • Export Citation
  • 34

    Garnett MR, , Puget S, , Grill J, & Sainte-Rose C: Craniopharyngioma. Orphanet J Rare Dis 2:18, 2007

  • 35

    Guiot G, & Derome P: [Indications for trans-sphenoid approach in neurosurgery. 521 cases.]. Ann Med Interne (Paris) 123:703712, 1972. (Fr)

    • Search Google Scholar
    • Export Citation
  • 36

    Hadad G, , Bassagasteguy L, , Carrau RL, , Mataza JC, , Kassam A, & Snyderman CH, : A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116:18821886, 2006

    • Search Google Scholar
    • Export Citation
  • 37

    Hargrave DR: Does chemotherapy have a role in the management of craniopharyngioma?. J Pediatr Endocrinol Metab 19:Suppl 1 407412, 2006

    • Search Google Scholar
    • Export Citation
  • 38

    Haupt R, , Magnani C, , Pavanello M, , Caruso S, , Dama E, & Garrè ML: Epidemiological aspects of craniopharyngioma. J Pediatr Endocrinol Metab 19:Suppl 1 289293, 2006

    • Search Google Scholar
    • Export Citation
  • 39

    Hoffman HJ: Surgical management of craniopharyngioma. Pediatr Neurosurg 21:Suppl 1 4449, 1994

  • 40

    Hofmann BM, , Höllig A, , Strauss C, , Buslei R, , Buchfelder M, & Fahlbusch R: Results after treatment of craniopharyngiomas: further experiences with 73 patients since 1997. Clinical article. J Neurosurg 116:373384, 2012

    • Search Google Scholar
    • Export Citation
  • 41

    Honegger J, , Buchfelder M, , Fahlbusch R, , Däubler B, & Dörr HG: Transsphenoidal microsurgery for craniopharyngioma. Surg Neurol 37:189196, 1992

    • Search Google Scholar
    • Export Citation
  • 42

    Hoogenhout J, , Otten BJ, , Kazem I, , Stoelinga GB, & Walder AH: Surgery and radiation therapy in the management of craniopharyngiomas. Int J Radiat Oncol Biol Phys 10:22932297, 1984

    • Search Google Scholar
    • Export Citation
  • 43

    Hussain I, , Eloy JA, , Carmel PW, & Liu JK: Molecular oncogenesis of craniopharyngioma: current and future strategies for the development of targeted therapies. A review. J Neurosurg 119:106112, 2013

    • Search Google Scholar
    • Export Citation
  • 44

    Jane JA Jr, , Kiehna E, , Payne SC, , Early SV, & Laws ER Jr: Early outcomes of endoscopic transsphenoidal surgery for adult craniopharyngiomas. Neurosurg Focus 28:4 E9, 2010

    • Search Google Scholar
    • Export Citation
  • 45

    Jane JA Jr, & Laws ER: Craniopharyngioma. Pituitary 9:323326, 2006

  • 46

    Jane JA Jr, , Prevedello DM, , Alden TD, & Laws ER Jr: The transsphenoidal resection of pediatric craniopharyngiomas: a case series. Clinical article. J Neurosurg Pediatr 5:4960, 2010

    • Search Google Scholar
    • Export Citation
  • 47

    Jho HD, Endoscopic transsphenoidal surgery. Schmidek HH: Schmidek & Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results ed 4 Philadelphia, WB Saunders, 2000. 1:385397

    • Search Google Scholar
    • Export Citation
  • 48

    Jho HD, & Carrau RL: Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. J Neurosurg 87:4451, 1997

  • 49

    Jho HD, & Ha HG: Endoscopic endonasal skull base surgery: Part 1—The midline anterior fossa skull base. Minim Invasive Neurosurg 47:18, 2004

    • Search Google Scholar
    • Export Citation
  • 50

    Julow J, , Lányi F, , Hajda M, , Szeifert G, , Simkovics M, & Tóth S, : Further experiences in the treatment of cystic craniopharyngeomas with yttrium 90 silicate colloid. Acta Neurochir Suppl (Wien) 42:113119, 1988

    • Search Google Scholar
    • Export Citation
  • 51

    Karavitaki N, , Brufani C, , Warner JT, , Adams CB, , Richards P, & Ansorge O, : Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up. Clin Endocrinol (Oxf) 62:397409, 2005

    • Search Google Scholar
    • Export Citation
  • 52

    Karavitaki N, , Cudlip S, , Adams CB, & Wass JA: Craniopharyngiomas. Endocr Rev 27:371397, 2006

  • 53

    Kassam A, , Snyderman CH, , Mintz A, , Gardner P, & Carrau RL: Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica. Neurosurg Focus 19:1 E3, 2005

    • Search Google Scholar
    • Export Citation
  • 54

    Kassam A, , Snyderman CH, , Mintz A, , Gardner P, & Carrau RL: Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum. Neurosurg Focus 19:1 E4, 2005

    • Search Google Scholar
    • Export Citation
  • 55

    Kassam AB, , Gardner PA, , Snyderman CH, , Carrau RL, , Mintz AH, & Prevedello DM: Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg 108:715728, 2008

    • Search Google Scholar
    • Export Citation
  • 56

    Kassam AB, , Prevedello DM, , Carrau RL, , Snyderman CH, , Thomas A, & Gardner P, : Endoscopic endonasal skull base surgery: analysis of complications in the authors' initial 800 patients. A review. J Neurosurg 114:15441568, 2011

    • Search Google Scholar
    • Export Citation
  • 57

    Kassam AB, , Prevedello DM, , Thomas A, , Gardner P, , Mintz A, & Snyderman C, : Endoscopic endonasal pituitary transposition for a transdorsum sellae approach to the interpeduncular cistern. Neurosurgery 62:3 Suppl 1 5774, 2008

    • Search Google Scholar
    • Export Citation
  • 58

    Kassam AB, , Thomas A, , Carrau RL, , Snyderman CH, , Vescan A, & Prevedello D, : Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap. Neurosurgery 63:1 Suppl 1 ONS44ONS53, 2008

    • Search Google Scholar
    • Export Citation
  • 59

    Kitano M, & Taneda M: Extended transsphenoidal surgery for suprasellar craniopharyngiomas: infrachiasmatic radical resection combined with or without a suprachiasmatic translamina terminalis approach. Surg Neurol 71:290298, 2009

    • Search Google Scholar
    • Export Citation
  • 60

    Komotar RJ, , Starke RM, , Raper DM, , Anand VK, & Schwartz TH: Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas. World Neurosurg 77:329341, 2012

    • Search Google Scholar
    • Export Citation
  • 61

    Koutourousiou M, , Gardner PA, , Fernandez-Miranda JC, , Tyler-Kabara EC, , Wang EW, & Snyderman CH: Endoscopic endonasal surgery for craniopharyngiomas: surgical outcome in 64 patients. Clinical article. J Neurosurg 119:11941207, 2013

    • Search Google Scholar
    • Export Citation
  • 62

    Larijani B, , Bastanhagh MH, , Pajouhi M, , Kargar Shadab F, , Vasigh A, & Aghakhani S: Presentation and outcome of 93 cases of craniopharyngioma. Eur J Cancer Care (Engl) 13:1115, 2004

    • Search Google Scholar
    • Export Citation
  • 63

    Laufer I, , Anand VK, & Schwartz TH: Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions. J Neurosurg 106:400406, 2007

    • Search Google Scholar
    • Export Citation
  • 64

    Laws ER, , Kanter AS, , Jane JA Jr, & Dumont AS: Editorial. Extended transsphenoidal approach. J Neurosurg 102:825828, 2005

  • 65

    Laws ER, , Weiss MH, & White WL: Craniopharyngioma. Skull Base 13:5558, 2003

  • 66

    Laws ER Jr: Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52:661666, 1980

  • 67

    Laws ER Jr: Transsphenoidal removal of craniopharyngioma. Pediatr Neurosurg 21:Suppl 1 5763, 1994

  • 68

    Laws ER Jr, & Vance ML: Radiosurgery for pituitary tumors and craniopharyngiomas. Neurosurg Clin N Am 10:327336, 1999

  • 69

    Leng LZ, , Brown S, , Anand VK, & Schwartz TH: “Gasket-seal” watertight closure in minimal-access endoscopic cranial base surgery. Neurosurgery 62:5 Suppl 2 ONSE342ONSE343, 2008

    • Search Google Scholar
    • Export Citation
  • 70

    Leng LZ, , Greenfield JP, , Souweidane MM, , Anand VK, & Schwartz TH: Endoscopic, endonasal resection of craniopharyngiomas: analysis of outcome including extent of resection, cerebrospinal fluid leak, return to preoperative productivity, and body mass index. Neurosurgery 70:110124, 2012

    • Search Google Scholar
    • Export Citation
  • 71

    Lin LL, , El Naqa I, , Leonard JR, , Park TS, , Hollander AS, & Michalski JM, : Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 1:126130, 2008

    • Search Google Scholar
    • Export Citation
  • 72

    Liu JK, , Das K, , Weiss MH, , Laws ER Jr, & Couldwell WT: The history and evolution of transsphenoidal surgery. J Neurosurg 95:10831096, 2001

    • Search Google Scholar
    • Export Citation
  • 73

    Loyo-Varela M, & Herrada-Pineda T: Infra-diaphragmatic craniopharyngioma in the adult. World Neurosurg [epub ahead of print], 2013

  • 74

    Maira G, , Anile C, , Colosimo C, & Cabezas D: Craniopharyngiomas of the third ventricle: trans-lamina terminalis approach. Neurosurgery 47:857865, 2000

    • Search Google Scholar
    • Export Citation
  • 75

    Maira G, , Anile C, , Rossi GF, & Colosimo C: Surgical treatment of craniopharyngiomas: an evaluation of the transsphenoidal and pterional approaches. Neurosurgery 36:715724, 1995

    • Search Google Scholar
    • Export Citation
  • 76

    Minamida Y, , Mikami T, , Hashi K, & Houkin K: Surgical management of the recurrence and regrowth of craniopharyngiomas. J Neurosurg 103:224232, 2005

    • Search Google Scholar
    • Export Citation
  • 77

    Mortini P, , Losa M, , Pozzobon G, , Barzaghi R, , Riva M, & Acerno S, : Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series. Clinical article. J Neurosurg 114:13501359, 2011

    • Search Google Scholar
    • Export Citation
  • 78

    Munari C, , Landre E, , Musolino A, , Turak B, , Habert MO, & Chodkiewicz JP: Long term results of stereotactic endocavitary beta irradiation of craniopharyngioma cysts. J Neurosurg Sci 33:99105, 1989

    • Search Google Scholar
    • Export Citation
  • 79

    Oliver CL, , Hackman TG, , Carrau RL, , Snyderman CH, , Kassam AB, & Prevedello DM, : Palatal flap modifications allow pedicled reconstruction of the skull base. Laryngoscope 118:21022106, 2008

    • Search Google Scholar
    • Export Citation
  • 80

    Park SW, , Jung HW, , Lee YA, , Shin CH, , Yang SW, & Cheon JE, : Tumor origin and growth pattern at diagnosis and surgical hypothalamic damage predict obesity in pediatric craniopharyngioma. J Neurooncol 113:417424, 2013

    • Search Google Scholar
    • Export Citation
  • 81

    Pascual JM, , Prieto R, & Carrasco R: Craniopharyngiomas involving the floor of the third ventricle. Acta Neurochir (Wien) 153:24472452, 2011. (Letter)

    • Search Google Scholar
    • Export Citation
  • 82

    Pascual JM, , Prieto R, & Carrasco R: Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category. Acta Neurochir (Wien) 153:24032426, 2011

    • Search Google Scholar
    • Export Citation
  • 83

    Pollock BE, , Lunsford LD, , Kondziolka D, , Levine G, & Flickinger JC: Phosphorus-32 intracavitary irradiation of cystic craniopharyngiomas: current technique and long-term results. Int J Radiat Oncol Biol Phys 33:437446, 1995

    • Search Google Scholar
    • Export Citation
  • 84

    Regine WF, , Mohiuddin M, & Kramer S: Long-term results of pediatric and adult craniopharyngiomas treated with combined surgery and radiation. Radiother Oncol 27:1321, 1993

    • Search Google Scholar
    • Export Citation
  • 85

    Rickert CH, & Paulus W: Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Childs Nerv Syst 17:503511, 2001

    • Search Google Scholar
    • Export Citation
  • 86

    Rutka JT: Editorial. Craniopharyngioma. J Neurosurg 97:12, 2002

  • 87

    Sainte-Rose C, , Puget S, , Wray A, , Zerah M, , Grill J, & Brauner R, : Craniopharyngioma: the pendulum of surgical management. Childs Nerv Syst 21:691695, 2005

    • Search Google Scholar
    • Export Citation
  • 88

    Samii M, & Samii A, Surgical management of craniopharyngiomas. Schmidek HH: Schmidek & Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results ed 4 Philadelphia, WB Saunders, 2000. 1:489502

    • Search Google Scholar
    • Export Citation
  • 89

    Scott RM, , Hetelekidis S, , Barnes PD, , Goumnerova L, & Tarbell NJ: Surgery, radiation, and combination therapy in the treatment of childhood craniopharyngioma—a 20-year experience. Pediatr Neurosurg 21:Suppl 1 7581, 1994

    • Search Google Scholar
    • Export Citation
  • 90

    Silva D, , Attia M, , Kandasamy J, , Alimi M, , Anand VK, & Schwartz TH: Endoscopic endonasal transsphenoidal “above and below” approach to the retroinfundibular area and interpeduncular cistern-cadaveric study and case illustrations. World Neurosurg 81:374384, 2014

    • Search Google Scholar
    • Export Citation
  • 91

    Snyderman C, , Kassam A, , Carrau R, , Mintz A, , Gardner P, & Prevedello DM: Acquisition of surgical skills for endonasal skull base surgery: a training program. Laryngoscope 117:699705, 2007

    • Search Google Scholar
    • Export Citation
  • 92

    Spaziante R, , De Divitiis E, , Irace C, , Cappabianca P, & Caputi F: Management of primary or recurring grossly cystic craniopharyngiomas by means of draining systems. Topic review and 6 case reports. Acta Neurochir (Wien) 97:95106, 1989

    • Search Google Scholar
    • Export Citation
  • 93

    Steno J, , Malácek M, & Bízik I: Tumor-third ventricular relationships in supradiaphragmatic craniopharyngiomas: correlation of morphological, magnetic resonance imaging, and operative findings. Neurosurgery 54:10511060, 2004

    • Search Google Scholar
    • Export Citation
  • 94

    Sweet HW, Craniopharyngiomas: a summary of data. Sweet HW: Schmidek & Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results ed 4 Philadelphia, WB Saunders, 2000. 1:477486

    • Search Google Scholar
    • Export Citation
  • 95

    Tabaee A, , Placantonakis D, , Schwartz TH, & Anand VK, Reconstruction after endoscopic skull base surgery. Anand VK, & Schwartz TH: Practical Endoscopic Skull Base Surgery San Diego, Plural Publishing, 2007. 191202

    • Search Google Scholar
    • Export Citation
  • 96

    Van Effenterre R, & Boch AL: Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg 97:311, 2002

  • 97

    Weiner HL, , Wisoff JH, , Rosenberg ME, , Kupersmith MJ, , Cohen H, & Zagzag D, : Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery 35:10011011, 1994

    • Search Google Scholar
    • Export Citation
  • 98

    Weiss M, , Sutton L, , Marcial V, , Fowble B, , Packer R, & Zimmerman R, : The role of radiation therapy in the management of childhood craniopharyngioma. Int J Radiat Oncol Biol Phys 17:13131321, 1989

    • Search Google Scholar
    • Export Citation
  • 99

    Weiss MH, The transnasal transsphenoidal approach. Apuzzo MLJ: Surgery of the Third Ventricle Baltimore, Williams & Wilkins, 1987. 476494

    • Search Google Scholar
    • Export Citation
  • 100

    Yaşargil MG, , Curcic M, , Kis M, , Siegenthaler G, , Teddy PJ, & Roth P: Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg 73:311, 1990

    • Search Google Scholar
    • Export Citation
  • 101

    Zanation AM, , Snyderman CH, , Carrau RL, , Kassam AB, , Gardner PA, & Prevedello DM: Minimally invasive endoscopic pericranial flap: a new method for endonasal skull base reconstruction. Laryngoscope 119:1318, 2009

    • Search Google Scholar
    • Export Citation
  • 102

    Zoicas F, , Droste M, , Mayr B, , Buchfelder M, & Schöfl C: GLP-1 analogues as a new treatment option for hypothalamic obesity in adults: report of nine cases. Eur J Endocrinol 168:699706, 2013

    • Search Google Scholar
    • Export Citation
  • 103

    Zuccaro G: Radical resection of craniopharyngioma. Childs Nerv Syst 21:679690, 2005

Metrics

All Time Past Year Past 30 Days
Abstract Views 657 440 38
Full Text Views 611 66 3
PDF Downloads 425 47 3
EPUB Downloads 0 0 0