Endoscopic endonasal approach for craniopharyngiomas

Fong, Reginald; Babu, C. S. J.; Schwartz, Theodore H.

doi:10.23736/s0390-5616.21.05097-9

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…With the development of endoscopic technology, the endonasal endoscopic approach (EEA) has been widely used in CP surgery. The EEA has no limitations of visualization, which can be extended to the transplanum and transtuberculum approaches that provide direct midline access to sellar, supra-sellar, retrochiasmatic, and third ventricular tumors [24]. In recent years, the EEA has been used for not only purely sellar CP but also suprasellar CP, even with intra-ventricular extension [25].…”

Section: Discussionmentioning

confidence: 99%

Risk Factor and Replacement Therapy Analysis of Pre- and Postoperative Endocrine Deficiencies for Craniopharyngioma

Cheng

Zhu

Wang

et al. 2023

Cancers

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Background: Pituitary hormone deficiency (PHD) is one of the most common symptoms and postoperative complications of craniopharyngiomas (CPs). However, the risk factors for PHD in CPs are little known. The purpose of this study was to analyze the risk factors of pre- and postoperative PHD and to investigate replacement therapy for CP patients. Methods: A retrospective study of 126 patients diagnosed with CP was performed. Univariate analysis was performed using Pearson’s chi-squared test or Fisher’s exact test, and a multiple logistic binary regression model was used to identify the influencing factors of pre- and postoperative PHD in craniopharyngioma. Results: Children and patients with hypothalamic involvement were more likely to have preoperative PHD. Patients with suprasellar lesions had a high risk of postoperative PHD, and preoperative PHD was a risk factor for postoperative PHD. Conclusion: Children have a high incidence of preoperative PHD. Preoperative PHD can serve as an independent risk factor for postoperative PHD. Preoperative panhypopituitarism can serve as an indication of pituitary stalk sacrifice during surgery. The management of replacement therapy for long-term postoperative endocrine hormone deficiency in patients with craniopharyngioma should be enhanced.

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Section: Discussionmentioning

confidence: 99%

Risk Factor and Replacement Therapy Analysis of Pre- and Postoperative Endocrine Deficiencies for Craniopharyngioma

Cheng

Zhu

Wang

et al. 2023

Cancers

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“…Over the last two decades, Endonasal Endoscopic Surgery (EES) has seen a growing utilization in the treatment of ACP, owing to its benefits of microinvasion and enhanced visualization (67)(68)(69). The 2020 EANS consensus statement on adult CP treatment advises utilizing the endonasal approach for midline CP, whereas transcranial approaches are suggested for lateral extension or purely intraventricular growth tumors (70).…”

Section: Endonasal Endoscopic Surgerymentioning

confidence: 99%

Advances in the treatment of Adamantinomatous craniopharyngioma: How to balance tumor control and quality of life in the current environment: a narrative review

Chen,

Ai,

Sun

2023

Front. Oncol.

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Adamantinomatous craniopharyngioma (ACP) presents a significant challenge to neurosurgeons despite its benign histology due to its aggressive behavior and unique growth patterns. This narrative review explores the evolving landscape of ACP treatments and their efficacy, highlighting the continuous development in therapeutic approaches in recent years. Traditionally, complete resection was the primary treatment for ACP, but surgical -related morbidity have led to a shift. The invasive nature of the finger-like protrusions in the histological structure results in a higher recurrence rate for ACP compared to papillary craniopharyngioma (PCP), even after complete macroscopic resection. Given this, combining subtotal resection with adjuvant radiotherapy has shown potential for achieving similar tumor control rates and potentially positive endocrine effects. Simultaneously, adjuvant treatments (such as radiotherapy, intracystic treatment, and catheter implantation) following limited surgery offer alternative approaches for sustained disease control while minimizing morbidity and alleviating clinical symptoms. Additionally, advances in understanding the molecular pathways of ACP have paved the way for targeted drugs, showing promise for therapy. There is a diversity of treatment models for ACP, and determining the optimal approach remains a subject of ongoing debate in the present context. In order to achieve a good-term quality of life (QOL), the main goal of the cyst disappearance or reduction of surgical treatment is still the main. Additionally, there should be a greater emphasis on personalized treatment at this particular stage and the consideration of ACP as a potentially chronic neurosurgical condition. This review navigates the evolving landscape of ACP therapies, fostering ongoing discussions in this complex field.

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“…Key pituitary hormones, including growth hormone/insulin-like growth factor, luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone/thyroxine, and adrenocorticotropic hormone/cortisol should be measured before surgery and hypocortisolism, hypothyroidism, and electrolyte balance should be corrected prior to operating [18]. In addition to these panels, a full neuro-opthalmologic exam with visual field testing should be performed [19]. Close collaboration with Endocrinology and Ophthalmology teams is critical for appropriate initial evaluation as well as postoperative monitoring and care.…”

Section: Key Pointsmentioning

confidence: 99%

Craniopharyngioma surgery for rhinologists

Salmon

Kshirsagar

Eide

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewCraniopharyngiomas are rare tumors that that present with loss of pituitary function in most cases. They present in a bimodal age distribution and the most common treatment paradigms include gross total resection or subtotal resection followed by radiation. Endoscopic transnasal access to intradural tumors has become increasingly common due to improvements in equipment, increased familiarity with the surgical corridor and anatomy, and reconstruction techniques. As such, rhinologists play an increasingly important role in the management of craniopharyngiomas. Recent findingsRecent years have highlighted our growing experience with pediatric endonasal skull base surgery. Prior concerns including sphenoid pneumatization, midfacial growth restrictions, and intercarotid space limitations have been studied more extensively. It has been found that there are no increased complications with lack of sphenoid pneumatization, no changes to midfacial growth with endonasal techniques, and the inter-carotid distance is stable after around age 5. Advances in surgical and skull base reconstruction techniques and intraoperative monitoring have reduced the risks of complications from surgery. SummaryRhinologists play an important role in craniopharyngioma surgery. The approach to and reconstruction after tumor removal are vital portions of the procedure that allow for resection and prevent postsurgical complications.

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Endoscopic endonasal approach for craniopharyngiomas

Cited by 8 publications

References 39 publications

Risk Factor and Replacement Therapy Analysis of Pre- and Postoperative Endocrine Deficiencies for Craniopharyngioma

Risk Factor and Replacement Therapy Analysis of Pre- and Postoperative Endocrine Deficiencies for Craniopharyngioma

Advances in the treatment of Adamantinomatous craniopharyngioma: How to balance tumor control and quality of life in the current environment: a narrative review

Craniopharyngioma surgery for rhinologists

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