title: Microscopic versus endoscopic approaches for craniopharyngiomas: choosing the optimal surgical corridor for maximizing extent of resection and complication avoidance using a personalized, tailored approach.
abstract: Resection remains the mainstay of treatment for craniopharyngiomas with the goal of radical resection, if safely possible, to minimize the rate of recurrence. Endoscopic endonasal and microscopic transcranial surgical approaches have both become standard methods for the treatment for craniopharyngiomas. However, the approach selection paradigm for craniopharyngiomas is still a point of discussion. Choosing the optimal surgical approach can play a significant role in maximizing the extent of resection and surgical outcome while minimizing the risks of potential complications. Craniopharyngiomas can present with a variety of different sizes, locations, and tumor consistencies, and each individual tumor has distinct features that favor one specific approach over another. The authors review standard cranial base techniques applied to craniopharyngioma surgery, using both the endoscopic endonasal approach and traditional open microsurgical approaches, and analyze factors involved in approach selection. They discuss their philosophy of approach selection based on the location and extent of the tumor on preoperative imaging as well as the advantages and limitations of each surgical corridor, and they describe the operative nuances of each technique, using a personalized, tailored approach to the individual patient with illustrative cases and videos.
authors.affiliation: Departments of 1 Neurological Surgery.|Otolaryngology-Head and Neck Surgery, and.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey.
authors.forename: James K
authors.initials: JK
authors.lastname: Liu
authors.affiliation: Departments of 1 Neurological Surgery.
authors.forename: Ilesha A
authors.initials: IA
authors.lastname: Sevak
authors.affiliation: Departments of 1 Neurological Surgery.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Carmel
authors.affiliation: Departments of 1 Neurological Surgery.|Otolaryngology-Head and Neck Surgery, and.|Ophthalmology and Visual Science, and.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey.
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D003397:Craniopharyngioma / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: EEA = endoscopic endonasal approach; approach selection; craniopharyngioma; endoscopic endonasal approach; endoscopic skull base surgery; microsurgical transcranial approach; retrochiasmatic