ǂa ǂcase series and a comprehensive review
Roman Bošnjak (Author), Mitja Benedičič (Author), Alenka Vittori (Author)

Abstract

Background. The choice of endoscopic expanded endonasal approach introduces the possibility of improved gross total resection of craniopharyngioma while minimizing surgical morbidity in a significant subset of patients. Methods. From our trans-sphenoidal surgical series of 331 cases, we retrospectively reviewed visual, endocrine and neuro-cognitive outcomes in the first consecutive eight patients (median age 63 years; range 4773 years) with newly diagnosed supradiaphragmatic craniopharyngioma (median tumour height 23 mm; range 1534 mm), removed by expanded endonasal approach (median follow-up 27 months; range 1069 months). Gross total resection was attempted in all patients. Results. Gross total resection was achieved in 6 of 8 patients. Visual improvement was present in 6 of 8 patients of patients or in 14 of 16 eyes. New endocrinopathy, including diabetes insipidus, appeared in 5 of 8 patients. Stalk was preserved in 4 patients. Cognitive decline was present in 2 cases. Five of 8 patients retained previous quality of life. Conclusions. Our early outcome results are comparable to the recent few expanded endonasal approach series, except for the incidence of new endocrinopathy and cerebrospinal fluid leak rate. This was influenced by higher number of transinfundibular tumours in our series, where stalk preservation is less likely, and not using nasoseptal flap or gasket closure in the first half of cases. Including data from the literature and ours, expanded endonasal approach shows a trend for improved gross total resection rate with less morbidity, more obviously for visual outcome and quality of life than for endocrine outcome. However, validity of expanded endonasal approach should be confirmed in a larger number of patients with a longer follow-up period.

Keywords

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Data

Language: English
Year of publishing:
Typology: 1.01 - Original Scientific Article
Organization: OI - Institute of Oncology
Publisher: Association of Radiology and Oncology
UDC: 616-006
COBISS: 1015980 Link will open in a new window
ISSN: 1318-2099
Parent publication: Radiology and oncology
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Other data

Secondary language: Slovenian
Secondary keywords: endoskopija;onkologija;radiologija;
URN: URN:NBN:SI
Pages: str. 266-279, V
Volume: ǂVol. ǂ47
Issue: ǂno. ǂ3
Chronology: sep. 2013
DOI: 10.2478/raon-2013-0036
ID: 23204826
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