title: Craniopharyngeal canal and its spectrum of pathology.
abstract: OBJECTIVE
  The craniopharyngeal canal is a rare, well-corticated defect through the midline of the sphenoid bone from the sellar floor to the anterosuperior nasopharyngeal roof. We reviewed a series of craniopharyngeal canals to determine a system of classification that might better our understanding of this entity, highlight the range of associated pathologic conditions, and optimize patient treatment.
  
  
  METHODS
  Available MR imaging, CT, and clinical data (from 1989-2013) of 29 patients (10 female, 15 male, 4 unknown; median age, 4 years; age range, 1 day-65 years) with craniopharyngeal canals were retrospectively examined. Qualitative assessment included orthotopic or ectopic adenohypophysis and the presence of a tumor and/or cephalocele. The midpoint anteroposterior diameter was measured. Clinical and imaging data were evaluated for pituitary dysfunction and accompanying anomalies.
  
  
  RESULTS
  Craniopharyngeal canals were qualitatively separated into 3 types: incidental canals (type 1); canals with ectopic adenohypophysis (type 2); and canals containing cephaloceles (type 3A), tumors (type 3B), or both (type 3C), including pituitary adenoma, craniopharyngioma, dermoid, teratoma, and glioma. Quantitative evaluation showed a significant difference (P < .0001) in the anteroposterior diameters of type 1 canals (median, 0.8; range, 0.7-1.1 mm), type 2 canals (median, 3.9, range, 3.5-4.4 mm), and type 3 canals (median, 9.0; range, 5.9-31.0 mm) imparting small, medium, and large descriptors. Canals with cephaloceles all contained an ectopic adenohypophysis. The craniopharyngeal canals were associated with pituitary dysfunction (6/29) and congenital anomalies (8/29).
  
  
  CONCLUSIONS
  Accurate diagnosis and classification of craniopharyngeal canals are valuable to characterize lesions requiring surgery, identify patients with potential pituitary dysfunction, and avoid iatrogenic hypopituitarism or CSF leak during surgical resection of nasopharyngeal masses.
authors.affiliation: From the Department of Radiology (T.A.A., K.L.S., H.R.H.), University of Utah, Salt Lake City, Utah.
authors.forename: T A
authors.initials: TA
authors.lastname: Abele
authors.forename: K L
authors.initials: KL
authors.lastname: Salzman
authors.forename: H R
authors.initials: HR
authors.lastname: Harnsberger
authors.forename: C M
authors.initials: CM
authors.lastname: Glastonbury
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000000981:diagnostic imaging / Q000473:pathology*; D004677:Encephalocele / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007018:Hypopituitarism / Q000000981:diagnostic imaging / Q000473:pathology; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D012658:Sella Turcica / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D013100:Sphenoid Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D013724:Teratoma / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult