Endoscopic endonasal craniopharyngioma resection.

Area of Science:

• Neurosurgery
• Endoscopic Skull Base Surgery
• Neuro-oncology

Background:

• Craniopharyngiomas are rare tumors often presenting with visual disturbances.
• Suprasellar and retrochiasmatic lesions can cause significant visual field defects like bitemporal hemianopsia.
• Surgical resection is the primary treatment modality for craniopharyngiomas.

Purpose of the Study:

• To present a case of craniopharyngioma resection using an endoscopic endonasal transsphenoidal and transplanum approach.
• To demonstrate the surgical technique for lesion removal and dural defect closure.
• To provide a high-definition video documentation of the surgical procedure.

Main Methods:

• A 21-year-old female patient with progressive bitemporal hemianopsia was evaluated.
• Cranial MR imaging confirmed a cystic suprasellar, retrochiasmatic lesion consistent with craniopharyngioma.
• The lesion was resected via an endoscopic endonasal transsphenoidal and transplanum approach.
• Dural defect closure was achieved using a fascia lata button and an autologous mucoperichondrial nasoseptal flap.

Main Results:

• Complete resection of the craniopharyngioma was achieved.
• The endoscopic endonasal approach facilitated minimally invasive access to the suprasellar region.
• Successful reconstruction of the dural defect was performed using specialized techniques.

Conclusions:

• Endoscopic endonasal transsphenoidal and transplanum approaches are effective for resecting suprasellar craniopharyngiomas.
• Minimally invasive techniques allow for complete tumor removal and safe reconstruction.
• This case highlights the utility of advanced endoscopic techniques in managing complex sellar region tumors.