Surgical removal of craniopharyngiomas by the transcranial approach through the lamina terminalis and sphenoid sinus.
We describe a method of attempting total removal of a craniopharyngioma using a subfrontal approach; dissection of the tumor from the brain stem, hypothalamus, and optic chiasm through the lamina terminalis; and then piecemeal removal of the tumor through the sphenoid sinus. Eleven patients treated by this approach are reported. In these patients, prior subfrontal operation did not affect outcome, but a prior transventricular operation or prior high dose radiation therapy made complete tumor removal less likely. We believe that this operation is one way to remove a craniopharyngioma that affords satisfactory exposure and reduces the chances of injury to the frontal lobes, hypothalamus, and optic pathways.
D000293:Adolescent; D000328:Adult; D002648:Child; D003397:Craniopharyngioma / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery; D014057:Tomography, X-Ray Computed