Outcomes After Endoscopic Endonasal Resection of Craniopharyngiomas within the Pediatric Inhabitants.
World Neurosurg. 2017 Dec;108:6-14
Authors: Patel VS, Thamboo A, Quon J, Nayak JV, Hwang PH, Edwards M, Patel ZM
BACKGROUND: Craniopharyngiomas have historically been handled by way of open transcranial approaches. Extra just lately, endoscopic transsphenoidal approaches have been more and more used; nevertheless, few case collection exist within the pediatric inhabitants.
METHODS: A retrospective evaluate of sufferers (aged <18 years) present process endoscopic transsphenoidal resection of craniopharyngiomas between 1995 and 2016 was carried out. Preoperative information included presenting signs, tumor dimension, location, and parts. Postoperative outcomes included symptom decision, visible outcomes, endocrine outcomes, illness recurrence, and main problems.
RESULTS: Sixteen pediatric sufferers with imply age of 11.zero years (vary, 5-15 years) had been included. The median follow-up time was 56.2 months. Imply maximal tumor diameter was three.98 cm. A lot of the tumors had suprasellar (93.eight%) and intrasellar (68.eight%) parts. The gross complete resection price was 93.eight%. The most typical presenting signs had been imaginative and prescient adjustments (81.three%) and elevated intracranial strain (56.three%). Most sufferers (66.7%) had their presenting signs resolved by their first postoperative go to. Imaginative and prescient improved or remained regular in 69.2% of sufferers. Postoperatively, new incidence of panhypopituitarism or diabetes insipidus developed in 63.6% and 46.7% of sufferers, respectively. New hypothalamic weight problems developed in 28.6% of sufferers. The postoperative cerebrospinal fluid leak price was 18.eight%. One affected person died of intraventricular hemorrhage postoperatively. The main complication price was 12.5%. Illness recurrence occurred in 1 affected person with gross complete resection (6.three%).
CONCLUSIONS: Endoscopic transsphenoidal resection for craniopharyngiomas can obtain excessive charges of complete resection with low charges of illness recurrence in bigger tumors than beforehand described. Nevertheless, hypothalamic-pituitary dysfunction and cerebrospinal fluid leak stay vital postoperative morbidities.
PMID: 28838874 [PubMed – indexed for MEDLINE]