Staged use of the transsphenoidal approach to resect superior third ventricular craniopharyngiomas

Craniopharyngiomas are benign tumors, usually originating from the infundibulum or tuber cinereum. Their surgical treatment is challenging because of their relationship to neural and vascular structures. Large craniopharyngiomas that invade the upper third of the third ventricle are a common reason for patients to need a second operation to accomplish a gross total resection. Transsphenoidal approaches are being increasingly used in the treatment of craniopharyngiomas. Large craniopharyngiomas involving the superior third ventricle are most commonly resected through a staged approach, often involving a transcortical or interhemispheric route.

The authors describe the use of an extended transsphenoidal approach as a second-stage operation to resect the intraventricular component of a large craniopharyngioma in an illustrative case.

The authors find this to be an excellent indication for an endoscopic extended transsphenoidal approach in selected cases.