title: The role of the endoscopic endonasal route in the management of craniopharyngiomas.
abstract: BACKGROUND
  Craniopharyngiomas represent one of the major challenges of neurosurgery. Surgical management of craniopharyngiomas classically required various transcranial approaches with the transsphenoidal route reserved for very selected cases. With the widespread use of endoscopes in endonasal surgery in the past decade, the extended endoscopic endonasal transtuberculum and transplanum approaches have been proposed as an alternative surgical route for removal of different types of suprasellar tumors, including solid craniopharyngiomas in patients with normal pituitary function and small sella.
  
  
  METHODS
  A detailed report is presented of the technique used by the authors for the endoscopic endonasal approach for the resection of craniopharyngiomas. For each type of craniopharyngioma, hints and anatomic "main landmarks" are provided throughout each step of the procedure.
  
  
  CONCLUSIONS
  The endoscopic endonasal approach offers advantages in the management of craniopharyngiomas that historically have been approached via the transsphenoidal route (i.e., purely intrasellar or intra-suprasellar infradiaphragmatic, preferably cystic lesions in patients with panhypopituitarism). Use of the "extended" endoscopic endonasal approach overcomes the limits of the transsphenoidal route to the sella enabling the management of different purely suprasellar and retrosellar cystic/solid craniopharyngiomas, regardless of the sellar size or pituitary function.
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy. Electronic address: lcavallo@unina.it.
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Cavallo
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Solari
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Esposito
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Villa
authors.affiliation: Department of Radiation Oncology, Sant'Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Minniti
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cappabianca
mesh_terms: D003397:Craniopharyngioma / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D009296:Nasal Cavity / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Craniopharyngioma; Endoscopy; Expanded endonasal approach; Transsphenoidal surgery