Transsphenoidal microsurgery in the management of craniopharyngioma

Abstract

The rationale for the transsphenoidal approach in the surgical management of craniopharyngioma is presented, based on experience with 26 cases. In 14 patients without prior therapy, 9 had total removal of the lesion, and only 2 had permanent postoperative diabetes insipidus. One operative death occurred in this group, and 2 patients had CSF leaks. In 12 patients who had undergone prior craniotomy, successful palliation was accomplished, at least temporarily, in every case. Vision was improved postoperatively in 15 of the 16 patients who presented with visual loss. Enlargement of the sella by the tumor is the critical feature allowing for successful transsphenoidal management.