Craniopharyngioma surgery in children: endocrine and visual outcome

Twenty-two children with craniopharyngioma were operated on in our Department of Neurosurgery from 1970 to 1981. Removal was total in 11 patients. There was one surgical death, but no recurrences in this group. Only partial removal could be performed in 10 children, followed by stereotactic radiotherapy in one. Recurrences have occurred in 4 of these children and 2 of them have died. In 1 child a biopsy was performed, followed by insertion of a shunt and stereotactic radiotherapy. Nine years after treatment there have still been no recurrences. Visual acuity was unchanged after the procedure in 17/21 survivors, improved in 1, and deteriorated in 3. The visual fields remained unchanged in 11, improved in 3, and deteriorated in 7. The visual fields and visual acuity were normal postoperatively in 5 patients. Hypopituitarism was more extensive after the procedure. We recommended an attempt at total removal whenever possible.