Purely neuroendoscopic transventricular management of cystic craniopharyngiomas.
BACKGROUND
This paper reports our series of cystic craniopharyngiomas treated using a purely neuroendoscopic approach.


METHODS
Drainage and wide marsupialization into CSF spaces (cysto-ventriculo-cisternostomy) were achieved to ensure mass effect control, continuous dilution, and reabsorption of the cyst's fluid. A steerable, flexible neuroendoscope and a pre-coronal approach were used in 7 patients harboring intra/paraventricular cysts (4 primary and 3 recurrent).


RESULTS
These surgical goals were achieved in all but one case and no procedure-related complications were observed. During the follow-up period (range 6-72 months; average 38.3 months) one recurrence and one progression of undrained pouch were observed at 25 and 30 months. Both patients underwent successful repeat neuroendoscopy.


CONCLUSIONS
In our hands, this technique has proven minimally invasive, safe, and effective; although oncologically palliative it can be implemented with other therapeutic modalities. Our preliminary experience should stimulate the recruitment of larger groups of patients in order to define the role of neuroendoscopy in the multimodal treatment of craniopharyngiomas.
U.O. di Neurochirurgia, Dipartimento di Neuroscienze G.M. Lancisi, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
Alberto
A
Delitala
Andrea
A
Brunori
Francesco
F
Chiappetta
D000293:Adolescent; D000328:Adult; D000368:Aged; D020863:Central Nervous System Cysts / Q000473:pathology / Q000601:surgery*; D002648:Child; D003397:Craniopharyngioma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods