Suprasellar pediatric craniopharyngioma resection via endonasal endoscopic approach

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• 作者：Zarina S. Ali (1) <br> Shih-Shan Lang (1) <br> Ameet R. Kamat (2) <br> Nithin D. Adappa (2) <br> James N. Palmer (2) <br> Phillip B. Storm (1) (3) <br> John Y. K. Lee (1) <br>
• 关键词：Craniopharyngioma ; Pediatric ; Endoscopic approaches ; Endoscopic transsphenoidal
• 刊名：Child's Nervous System
• 出版年：2013
• 出版时间：November 2013
• 年：2013
• 卷：29
• 期：11
• 页码：2065-2070
• 全文大小：
• 作者单位：Zarina S. Ali (1) <br> Shih-Shan Lang (1) <br> Ameet R. Kamat (2) <br> Nithin D. Adappa (2) <br> James N. Palmer (2) <br> Phillip B. Storm (1) (3) <br> John Y. K. Lee (1) <br><br>1. Department of Neurosurgery, University of Pennsylvania, 3400 Spruce Street, 3rd Floor Silverstein Pavilion, Philadelphia, PA, 19104, USA <br> 2. Department of Otorhinolaryngologyead and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA <br> 3. Division of Neurosurgery, The Children Hospital of Philadelphia, Philadelphia, PA, USA <br>
• ISSN：1433-0350

文摘

Purpose Purely endoscopic endonasal approaches to surgical resection of pediatric suprasellar craniopharyngiomas are uncommonly performed. The aim of the study is to assess the feasibility and to describe the short-term outcomes of endonasal endoscopic approaches for the gross total resection of suprasellar craniopharyngiomas in the pediatric population. Methods A combined neurosurgicaltolaryngologic team performed gross total resection of craniopharyngiomas in seven pediatric patients (mean age 9.6years) at The Children Hospital of Philadelphia over 2011012. Short-term outcomes were analyzed over a mean follow-up period of 6.3months. Results All tumors involved the sellar and/or suprasellar space and contained some cystic component. The mean maximal tumor diameter was 31.5mm (range 18.52.0mm). Using a binostril approach, gross total tumor resection was obtained in all patients (100%). All patients with preoperative visual dysfunction demonstrated improvement in visual acuity. New or stable panhypopituitarism was observed in all cases. All patients developed postoperative diabetes insipidus, and cerebrospinal fluid leak occurred in one patient (15%). Conclusions Complete radiographic resection of pediatric craniopharyngioma can be achieved via a purely endoscopic endonasal approach. In particular, this approach can be performed safely using the wo-nostrils-four-handstechnique with intraoperative neuronavigation. This approach should be highly considered in patients with progressive visual dysfunction. Further studies are needed to characterize the long-term surgical and clinical outcome of pediatric patients treated with this surgical approach.