Endoscopic extended transsphenoidal resection of craniopharyngiomas: nuances of neurosurgical technique

摘要: Endoscopic approaches to the midline ventral skull base have been extensively developed and refined for resection of cranial tumors over past several years. As these techniques improved, both degree complication rates proven comparable those transcranial approaches, while visual outcomes may be better via endoscopic endonasal surgery hospital stays recovery times are often shorter. Yet all progress made, steep learning curve associated with has hampered more widespread implementation adoption. The authors address this obstacle by coupling a thorough description technical nuances craniopharyngioma detailed illustrations important steps in operation. Traditionally, transsphendoidal craniopharyngiomas restricted lesions mostly confined sella. However, recently, resections frequently employed extrasellar purely third ventricle craniopharyngiomas, whose typical retrochiasmatic location makes them ideal candidates transnasal surgery. approach offers many advantages, including direct access long axis tumor, early tumor debulking minimal manipulation optic apparatus, precise visualization planes, particularly along undersurface chiasm roof ventricle, minimal-access corridor that obviates need brain retraction. Although much emphasis placed on tenets exposure "how get there," article focuses "when you there." Three operative videos illustrate our discussion tenets.