Document Detail


The petrosal approach for the total removal of giant retrochiasmatic craniopharyngiomas in children.
MedLine Citation:
PMID:  17330531     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The surgical removal of retrochiasmatic craniopharyngiomas, particularly those of giant size, remains a formidable challenge. The posterior petrosal (or presigmoid transtentorial) approach provides wide, direct exposure of these tumors, which allows safe neurovascular dissection and facilitates their total removal. METHODS: Two patients, one 7-year-old girl and one 4-year-old girl, harboring giant retrochiasmatic craniopharyngiomas underwent total resection via the posterior petrosal approach. Both patients had good outcomes, and no evidence of recurrence was noted in either patient after 3 years of follow up. The surgical technique used in these patients is described. The trajectory of the petrosal approach is posterior-to-anterior and inferior upward. This is particularly valuable for dissecting the upper portion of the tumor, which projects high into the third ventricle. Using this approach, the surgeon can achieve direct visualization for dissection of the hypothalamus and pituitary stalk, while maintaining the blood supply to these structures and preserving their functional integrity. The small and poorly aerated mastoid sinus in children does not contraindicate the use or diminish the advantages of the petrosal approach. CONCLUSIONS: The authors recommend this approach for patients with large or giant retrochiasmatic craniopharyngiomas.
Authors:
Ossama Al-Mefty; Samer Ayoubi; Paulo A S Kadri
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  106     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-03-02     Completed Date:  2007-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  87-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock 72205, USA. keelandamye@uams.edu
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Craniopharyngioma / pathology,  surgery*
Craniotomy / methods
Dissection / methods
Female
Follow-Up Studies
Humans
Hypothalamus / pathology
Optic Chiasm / pathology
Petrous Bone / surgery*
Pituitary Neoplasms / pathology,  surgery*
Third Ventricle / pathology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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