Radical resection of a craniopharyngioma via the extradural anterior temporal approach with zygomatic arch osteotomy

Ota, Nakao; Tanikawa, Rokuya; Miyama, Masataka; Miyazaki, Takanori; Kinoshita, Yu; Matsukawa, Hidetoshi; Yanagisawa, Takeshi; Sakakibara, Fumihiro; Saito, Norihiro; Maeda, Shiro; Noda, Kosumo; Tsuboi, Toshiyuki; Takeda, Ryo; Kamiyana, Hiroyasu; Tokuda, Sadahisa

doi:10.4103/2152-7806.196774

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…Craniopharyngiomas are considered to be most effectively treated by a total excision. [1718192021] This is beset with many problems due to the close relationship of the tumors to the optic apparatus, carotid arteries, and the hypothalamus. [19] Some tumors infiltrate into the hypothalamus,[22] limited space between the chiasma, and the need to exert constant traction on the tumor during excision.…”

Section: Discussionmentioning

confidence: 99%

A case series of craniopharyngioma: Epidemiological study and management analysis at tertiary care center

Ramanbhavana

Prasad

2019

Asian J Neurosurg

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Introduction:Debate continues as to the optimal treatment for craniopharyngioma; radical surgical resection or partial resection followed by radiotherapy. Radical surgical resection may be complicated by intraoperative injury to surrounding structures and stormy postoperative hormonal problems. This study aims to examine the result of safe maximal surgical resection.Methodology:Retrospective study of all histopathologically proven craniopharyngiomas who had undergone surgical resection over an almost 4-year period was included. Data were collected reviewing demography, clinical presentation, hormonal dysfunction, extent of resection, and visual deterioration. Outcome was measured in terms of Glasgow Outcome Scale and recurrence.Results:Of 41 patients, 20(48.8%) were male and 21(51.2%) were female. Age of patients ranged from 1 to 59 years with a mean of 15.9 years. Thirty-seven patients (90%) had headache, 32 patients (78%) had visual disturbances, 23 patients (56%) had vomiting, and 10 patients (24%) had convulsions. Six patients (15%) had memory and sleep disorders and three patients of those >15 years (12.5%) had amenorrhea/sexual dysfunction. Patients who had surgery followed by radiotherapy had better prognosis, so also those aged 18 or less compared to older, males better than females and those without headache had better prognosis, though not statistically significant.Conclusions:Gross total excision if judiciously decided intraoperatively has a favorable outcome with acceptable morbidity. Patient has better prognosis who has surgery with radiotherapy.

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Section: Discussionmentioning

confidence: 99%

A case series of craniopharyngioma: Epidemiological study and management analysis at tertiary care center

Ramanbhavana

Prasad

2019

Asian J Neurosurg

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The Subtemporal Approach to the Lateral Midbrain with and without Zygomatic Osteotomy: An Anatomical Study

et al. 2019

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The subtemporal approach provides a narrow operative corridor to the crus cerebrum and adjacent structures of the crural, interpeduncular, and ambient cistern. Addition of a zygomatic osteotomy widens this narrow corridor and spares retraction of the temporal lobe. We investigate and compare the morphometric parameters of the subtemporal approach with versus without zygomatic osteotomy. On each side of four cadaveric heads, a temporal craniotomy was performed to gain access to the crus cerebrum and adjacent subarachnoid cisterns using a subtemporal approach. Operative corridor width and corridor working angle were measured with and without brain retraction on each specimen side. Next, a zygomatic osteotomy was performed followed by full downward reflection of the temporalis muscle and further drilling of the squamous part of the temporal bone. Lastly, operative corridor width and corridor working angle were measured again for comparison. The subtemporal operating corridor was (mean/SD): 5.8/2.6 mm without retraction, 11.4/4.3 mm with retraction, and 13.5/6.5° working angle. After addition of a zygomatic osteotomy, the operative corridor was 8/9.2/4.3 mm without retraction, 14.7/4.5 mm with retraction, 31.8/3.1° working angle. Zygomatic osteotomy significantly increased the operative corridor working angle of the subtemporal approach. Furthermore, we demonstrate a direct approach into the interpeduncular fossa. Clin. Anat. 32:710–714, 2019. © 2019 Wiley Periodicals, Inc.

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Radical resection of a craniopharyngioma via the extradural anterior temporal approach with zygomatic arch osteotomy

Cited by 2 publications

References 39 publications

A case series of craniopharyngioma: Epidemiological study and management analysis at tertiary care center

A case series of craniopharyngioma: Epidemiological study and management analysis at tertiary care center

The Subtemporal Approach to the Lateral Midbrain with and without Zygomatic Osteotomy: An Anatomical Study

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