Status of vision following surgical treatment of craniopharyngiomas

The authors report visual results in a series of 42 patients with craniopharyngiomas. Visual abnormalities were present in 91% of the children and in 83% of the adults. Total removal was achieved in 16 patients with 3 postoperative deaths and subtotal removal in 26 patients with only one postoperative death. Of the 38 survivors, 63% improved, 26% remained the same and 10% worsened. When analyzing the influence of factors such as age, nature and location of the tumour, extent of removal, surgical approach, use of CT scan facilities and duration and degree of the deficit in the 31 survivors with preoperative visual impairment, it became apparent that only the duration and degree of preoperative visual deficit had a significant influence the outcome. The authors discuss also the suggestion that a conservative attitude may be associated with better visual results.