Primary transsphenoidal microsurgery in the treatment of craniopharyngiomas

Thirty craniopharyngiomas were operated on between 1983 and 1993. Eight patients underwent surgery solely via the transsphenoidal route. None of these had undergone surgery previously. The eight patients were followed up for a period of 120 months (mean 87.5 months). The tumour was removed totally in five and subtotally in three patients. All eight patients had one or more endocrine abnormalities prior to surgery. Five patients presented with visual field defects or decreased visual acuity, which improved postoperatively in all cases. Seven received radiotherapy, with one declining this treatment. No recurrences have occurred during follow-up in any of the group. Primary transsphenoidal surgery is a both safe and effective treatment for those craniopharyngiomas that are located within an enlarged sella, have no calcification and are not adherent to parasellar structures.