Extended Endoscopic Endonasal Approach for Craniopharyngioma Removal.

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Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_8BF6DB78B3CC
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Extended Endoscopic Endonasal Approach for Craniopharyngioma Removal.
Journal
Journal of neurological surgery. Part B, Skull base
Author(s)
Messerer M., Maduri R., Daniel R.T.
ISSN
2193-6331 (Print)
ISSN-L
2193-634X
Publication state
Published
Issued date
02/2018
Peer-reviewed
Oui
Volume
79
Number
2
Pages
S199-S200
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
javax.xml.bind.JAXBElement@5557f33c
 Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. javax.xml.bind.JAXBElement@15153a37  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig. 1 , panels A and B). javax.xml.bind.JAXBElement@6796b562  The head is rotated 10 degrees toward the surgeons. The nasal step is started through the left nostril with a middle turbinectomy. A nasoseptal flap is harvested and positioned in the left choana. The binostril approach allows a large sphenoidotomy to expose the key anatomic landmarks. The craniotomy boundaries are the planum sphenoidale superiorly, the median opticocarotid recesses, the internal carotid artery laterally and the clival recess inferiorly. After dural opening and superior intercavernous sinus coagulation, the tumor is entirely removed ( Fig. 2 , panels A and B). Skull base reconstruction is ensured by fascia lata grafting and nasoseptal flap positioning. javax.xml.bind.JAXBElement@65eac187  Postoperative MRI showed the complete tumor resection ( Fig. 1 , panels C and D). At 3 months postoperatively, the bitemporal hemianopia regressed and the visual acuity improved. A novel left homonymous hemianopia developed secondary to optic tract manipulation. javax.xml.bind.JAXBElement@f4e1015  The extended EEA is a valid surgical approach for craniopharyngioma resection. A comprehensive knowledge of the sellar and parasellar anatomy is mandatory for safe tumor removal with decreased morbidity and satisfactory oncologic results. The link to the video can be found at: https://youtu.be/NrCPPnVK2qA .

Keywords
craniopharyngioma, endoscopy, extended endonasal approach, parasellar lesions, transsphenoidal surgery
Pubmed
Web of science
Open Access
Yes
Create date
08/02/2018 17:58
Last modification date
20/08/2019 14:50
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