Endoscopic endonasal surgery for craniopharyngiomas: a series of 60 patients.

Endoscopic endonasal surgery for craniopharyngiomas: a series of 60 patients.

World Neurosurg. 2019 Jan 02;:

Authors: Mou J, Wang X, Huo G, Ruan L, Jin K, Tan S, Wang F, Hua H, Yang G

Abstract
OBJECTIVE: To report our experience of the management of 60 craniopharyngioma patients with endoscopic endonasal surgery (EES) and evaluate the feasibility and safety of EES for craniopharyngiomas.
METHOD: The clinical data of 60 craniopharyngioma patients who underwent EES between November 2014 and December 2017 were analysed retrospectively. All patients had vascularized nasoseptal flaps, and the most recent 4 patients had "in situ bone flaps" for better skull base reconstruction. Visual improvements, tumour resection extents, recurrence rates, endocrine functional changes and surgical complications were evaluated.
RESULTS: The resection rates were as follows: gross-total,68.3% (41 patients); near-total (>95% of tumour removed),15% (9 patients); subtotal (≥80% of tumour removed),10% (6 patients), and partial (PR<80% of tumour removed)6.7% (4 patients). Fifty-two patients presented with visual impairment; of these, 46 (88.5%) improved or returned to normal after surgery. Regarding the 32 patients with hypopituitarism before surgery, pituitary function was unchanged in 15 (46.8%), improved or normalized in 4 (12.5%) and deteriorated in 13 (40.6%). Eleven patients (18.3%) suffered from diabetes insipidus before treatment, and 27 more patients had this condition after surgery. Twenty-two patients had hyposmia postoperatively, and 17 patients experienced significant weight gain. Four patients had recent memory loss, and two of them had a temporary recent mental disorder. Three (5%) patients had CSF leakage after surgery. Three patients (5%) contracted meningitis and were cured with antibiotic treatment. One patient showed recurrence by MRI re-examination, at the mean follow-up time of 22 months (range, 8-45 months; SD, 11 months).

PMID: 30610976 [PubMed - as supplied by publisher]

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