[Microsurgical treatment for craniopharyngioma combined transorbital-subfrontal and temporal craniotomy].
OBJECTIVE
To summarize the experience in microsurgical removal of craniopharyngioma using combined transorbital-subfrontal and temporal craniotomy.


METHODS
Eighteen patients with craniopharyngioma varied from 3.1 cm to 6.2 cm in diameter. The tumor was located in the suprasellar region in 7 patients, extended to the third ventricle in 6, and down to the intrasellar from the suprasellar region in 4, and in the third ventricle in 1. Complete or partial cystic tumor was seen in 13 patients, and solid tumor in 5, and calcified tumor in 12. All the patients were operated on via combined transorbital subfrontal and temporal approach. The tumor was dissected in the spaces I, II and IV with great attention to the preservation of the perforating arteries from the carotid, posterior communication and anterior choroidal arteries to the structure of the hypothalamus. The solid portion of the tumor was removed by piecemeal.


RESULTS
The tumor was totally removed in 14 patients and subtotally in 4. Postoperation, follow-up for 8 to 41 months showed no change in 3 residual tumors and one lost to follow-up. All patients Postoperative Karnofsky scales showed 80 - 90, in 12 patients, 60 - 70 in 5 patients, and 50 in 1.


CONCLUSIONS
Combined transorbital-subfrontal and temporal approach can provide an excellent exposure to the sellar region, craniopharyngioma and its surrounding structures. This approach ensures less cerebral retraction for easy access to craniopharyngioma, including other large neoplasm of the middle cranial base with ventricle or posterior cranial base extension. Microsurgical techniques play an important role in removing tumor and preserving hypothalamic function.
Chen
Li-hua
LH
Department of Neurosurgery, Xiangya Hospital, Central-South University, Changsha 410008, China.
Liu
Yun-sheng
YS
Yuan
Xian-rui
XR
Fang
Jia-sheng
JS
Ma
Jian-rong
JR
Xi
Jian
J
Yang
Zhi-quan
ZQ
Huo
Lei
L
D000293:Adolescent; D000328:Adult; D002648:Child; D003397:Craniopharyngioma / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult