Suprabrow minicraniotomy for suprasellar tumours

We present our experience with suprabow minicraniotomy in the excision of 18 suprasellar tumours between May 2001 and September 2003. There were 14 females and four males with ages ranging from 7 to 59 years. The tumours included one epidermoid cyst, 10 meningiomas, five craniopharyngiomas and two optico-chiasmatico-hypothalamic (OCHG) gliomas. The size of the one-piece craniotomy was about 2.5 cm. Both OCHGs were biopsied; one craniopharyngioma was totally excised, the remaining craniopharyngiomas and epidermoid cyst were subtotally excised. Four meningiomas were radically excised and six were subtotally removed. The patient with a craniopharyngioma that had a radical excision died of hypothalamic dysfunction. One patient developed a postoperative meningitis and subsequent hydrocephalus requiring a shunt. The other patients did well and the cosmetic result was excellent in all cases. This basal approach through a small craniotomy provided good surgical access to suprasellar tumours with minimal brain retraction.