Minimally invasive management of adult craniopharyngiomas: An analysis of our series and review of literature

Rahmathulla, Gazanfar; Barnett, Gene H.

doi:10.4103/2152-7806.121612

Cited by 13 publications

(4 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 This is evident in multiple case series in which recurrence rates range from 24.8-100% after performing STR, as compared to recurrence rates ranging from 0-52.1%% after GTR (Table 1, follow-up 2.2-10 years). 6,7,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] In 1996 Eldevik et al examined only CP patients who underwent STR and reported that the addition of radiation reduced recurrence from 85.6% to 35%. 15 Multiple other studies have corroborated this finding, demonstrating that the addition of RT to STR reduced recurrence rates to 14-37.5%, which is comparable to the recurrence rates achieved after GTR in multiple series.…”

Section: Gtr Versus Str Recurrence Ratesmentioning

confidence: 99%

Gross Total Versus Subtotal Surgical Resection in the Management of Craniopharyngiomas

Grewal

Spielman

Safi

et al. 2020

Allergy�Rhinol (Providence)

View full text Add to dashboard Cite

Craniopharyngiomas (CP) are suprasellar tumors that can grow into vital nearby structures and thus cause significant visual, endocrine, and hypothalamic dysfunction. Debate persists as to the optimal treatment strategy for these benign lesions, particularly with regards to the extent of surgical resection. The goals of tumor resection are to eliminate the compressive effect of the tumor on surrounding structures and minimize recurrence. It remains unclear whether a gross total resection (GTR) or subtotal resection (STR) with adjuvant therapy confers a better prognosis. Chemotherapy and radiation therapy (RT) have been explored as both neoadjuvant and adjuvant treatments to decrease tumor burden and prevent recurrence. The objective of this paper is to review the risks and benefits of GTR versus STR, specifically with regard to risk of recurrence and postoperative morbidity. Aggregated data suggest that STR monotherapy is associated with higher rates of recurrence relative to GTR (50.6% ± 22.1% vs 20.2% ± 13.5%), while STR combined with RT leads to recurrence rates similar to GTR. However, both GTR and RT are independently associated with higher rates of comorbidities including panhypopituitarism, diabetes insipidus, and visual deficits. The treatment strategy for CPs should ultimately be tailored to each patient’s individual tumor characteristics, risk, symptoms, and therapeutic goals.

show abstract

Section: Gtr Versus Str Recurrence Ratesmentioning

confidence: 99%

Gross Total Versus Subtotal Surgical Resection in the Management of Craniopharyngiomas

Grewal

Spielman

Safi

et al. 2020

Allergy�Rhinol (Providence)

View full text Add to dashboard Cite

show abstract

“…Previous evidence investigated ORS in managing CP, it was predominantly of cystic type, [18][19][20][21] and others were of mixed type (partially cystic and partially solid). 22 In our cases, 73% needed no re-aspiration, 19% of patients needed re-aspiration every 6 months, and 8% needed it every 3 months but remained stable without symptoms of increased ICP.…”

Section: Discussionmentioning

confidence: 50%

“…In our study, all cases were of the enhanced cystic type, three cases were of a calcified wall, and four cases presented with hydrocephalus that needed a VP shunt. Previous evidence investigated ORS in managing CP, it was predominantly of cystic type, 18‐21 and others were of mixed type (partially cystic and partially solid) 22 . In our cases, the tumour cysts appear to stabilize after catheter placement without the need for repeated aspirations; of the 12 patients included, only one case needed re‐aspiration since the cyst size on follow‐up increased.…”

Section: Discussionmentioning

confidence: 59%

Surgical results of using the Ommaya reservoir system for the management of cystic craniopharyngiomas: A retrospective single‐centre experience

Mohamed

Shalaby

2023

Surgical Practice

View full text Add to dashboard Cite

Background: The management options for cystic craniopharyngioma (CP) are controversial. Surgical resection (gross or partial), radiotherapy, chemotherapy, cyst aspiration, and Ommaya reservoir system (ORS) implantations are the options for management that are used individually or in combination, but the ideal treatment is unclear.Objective: We aimed to investigate the functional outcomes and the complications of Ommaya reservoir system (ORS) insertion as a treatment option for cystic CP.Methods: Between January 2018 and January 2020, 12 patients with enhanced cystic CP were treated by cyst fenestration and aspiration on the day of surgery, and an ORS was inserted. The period between the procedure time and the last outpatient visit was considered the follow-up period. Results:The main presenting symptoms were increased intracranial pressure, visual defects, and hormonal changes. The clinical symptoms improved, and the tumour cysts appeared to stabilize after catheter placement without the need for repeated aspirations; of the 12 patients included, only one case needed re-aspiration. The eight patients who had signs of increased intracranial pressure reported resolved symptoms (100%). Of the 12 patients, seven and six patients showed improved visual acuity and improved visual field defect. Conclusion:Cyst fenestration and insertion of ORS is a safe and effective treatment option for cystic CP. ORS can be used in de novo cases as a treatment option alone without further invasive treatment to alleviate symptoms and improve clinical status, especially the visual changes.

show abstract

“…Intraoperative fenestration of the cyst wall usually drains the dense liquid content, typically described as 'engine oil' in color and texture [2]; spillage of the cyst contents into spaces containing cerebrospinal fluid (CSF) may lead to chemical meningitis and possibly secondary hydrocephalus [32]. Some authors advocate inserting a catheter with an Ommaya reservoir to allow for intermittent drainage, combined with radiation therapy [51]; long-term catheter placement, however, is associated with risks of infection, catheter displacement, content re-accumulation due to cyst septations, and pain with Ommaya reservoir tapping. Remarkably, none of the NTVA studies summarized in Table 1 The low complication and recurrence rates (Table 1 and Table 3) following NTVA, as well as the endoscopic endonasal approach, compared to microsurgery and Ommaya reservoir insertion, support the validity of these minimally invasive techniques as credible and potentially better alternatives in the management of CC or cystic-dominant craniopharyngiomas.…”

Section: Discussionmentioning

confidence: 99%

Neuroendoscopic Transventricular Approach for Cystic Craniopharyngioma

Noureldine

Khodmehr

Sabahi

et al. 2021

Cureus

View full text Add to dashboard Cite

The literature is rich with many studies reporting different treatment modalities and approaches for cystic craniopharyngioma (CC), including microsurgery, neuroendoscopic transventricular approach, endoscopic transnasal surgery, stereotactic drainage, and Ommaya reservoir insertion. The goals of this manuscript are to report the successful treatment of an atypical case of CC using the neuroendoscopic transventricular approach (NTVA) as well as discuss the different surgical modalities for these tumors following a comprehensive review of the literature. Our patient is a nine-year-old female with a large CC who was managed using the NTVA. No complications or recurrence occurred over two years of follow-up. Results of our literature review showed lower recurrence and complication rates of the NTVA compared to other surgical modalities. The NTVA is potentially efficient, reliable, and safe for managing CC and cysticdominant craniopharyngiomas, with low recurrence and complication rates compared to microsurgery and Ommaya reservoir insertion. Future randomized clinical studies comparing the various treatment modalities of CC are needed to solidify these conclusions.

show abstract

Minimally invasive management of adult craniopharyngiomas: An analysis of our series and review of literature

Cited by 13 publications

References 65 publications

Gross Total Versus Subtotal Surgical Resection in the Management of Craniopharyngiomas

Gross Total Versus Subtotal Surgical Resection in the Management of Craniopharyngiomas

Surgical results of using the Ommaya reservoir system for the management of cystic craniopharyngiomas: A retrospective single‐centre experience

Neuroendoscopic Transventricular Approach for Cystic Craniopharyngioma

Contact Info

Product

Resources

About