Craniopharyngioma--analysis of surgical procedure

Twenty cases of craniopharyngiomas treated surgically between 1972 and 1979 have been studed neuro-ophthalmologically. The visual fields demonstrated asymetrical bitemporal hemianopsia, occasionally homonymous hemianopsia and central scotomas. The visual function was followed up for a period of one to 8 years after the operation. Improvement and retention of the visual function were observed in 88% of cases with subtotal resection and irradiation, 45% of cases with partial resection and irradiation, and 0% of totally resected cases. Histopathologically, the dense adhesion and tumor invasion in the optic chiasm were observed in autopsy cases. From the viewpoint of operative results and autopsy findings, the subtotal excision with irradiation is advocated for the treatment of craniopharyngiomas, particularly in the adult cases.