Lamina terminalis approach for retrochiasmal craniopharyngiomas

The retrochiasmal location of a tumour and the presence of a prefixed chiasm pose a major difficulty in total excision of craniopharyngiomas. An approach through the lamina terminalis gives direct access to these lesions, which are situated predominantly in the midline. Our experience with total excision of six such tumours exclusively through the lamina terminalis route is presented. Despite a stormy postoperative course due to water and electrolyte imbalance, no mortality resulted and minimal long-term morbidity was observed. Total excision was confirmed in all the cases by postoperative computed tomography scans.