Document Detail


The role of transsphenoidal surgery in the treatment of craniopharyngiomas.
MedLine Citation:
PMID:  15035280     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The optimal approach for the surgical treatment of craniopharyngiomas is still debated. In all cases involving the sella turcica, the authors have exclusively used transsphenoidal surgery (TSS), assuming that this approach is less traumatic than an intracranial one. Moreover, TSS was also performed in some cases of purely suprasellar craniopharyngiomas. In this study the surgical indications and the results obtained in all patients who had undergone TSS were analyzed. METHODS: In a series of 92 patients who underwent surgery for craniopharyngiomas, TSS was the first choice of approach in 57 cases (62%) consisting of 29 female and 28 male patients with ages ranging from 12 to 79 years (mean 35 years). The follow-up duration ranged from 2 to 20 years. A standard transsphenoidal approach was used in patients with an exclusively intrasellar (11 patients) or an intrasellar and suprasellar tumor (37 patients); in nine cases of tumors located exclusively above the sella turcica, a transsphenoidal presellar approach (seven patients) or a transsellar-transdiaphragmatic approach (two patients) was used. Total removal was performed in 36 patients (63%). All patients had good clinical results. Postoperative cerebrospinal fluid leakage occurred in 10 cases, but only one case required a surgical repair of the sella. Two patients died of late complications (3.5%). There were eight cases (14%) of tumor regrowth. CONCLUSIONS: The authors assert that, when used in appropriately located craniopharyngiomas and by neurosurgeons with extensive experience in pituitary surgery, TSS offers excellent results with minor risks.
Authors:
Giulio Maira; Carmelo Anile; Alessio Albanese; Daniel Cabezas; Flaminia Pardi; Andrea Vignati
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  100     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-23     Completed Date:  2004-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445-51     Citation Subset:  AIM; IM    
Affiliation:
Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy. gmaira@rm.unicatt.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cerebrospinal Fluid Otorrhea / etiology
Child
Craniopharyngioma / pathology,  surgery*
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Neoplasm Staging
Neurosurgical Procedures / methods
Pituitary Neoplasms / pathology,  surgery*
Postoperative Complications
Preoperative Care
Sella Turcica / pathology,  surgery*
Sphenoid Bone / surgery

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


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