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JOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery


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Journal of Neurosurgical Sciences 2018 Feb 23

DOI: 10.23736/S0390-5616.18.04376-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Limits of transsellar/transtuberculum surgery for craniopharyngioma

Maria KOUTOUROUSIOU 1, Juan C. FERNANDEZ-MIRANDA 1, Eric W. WANG 2, Carl H. SNYDERMAN 2, Paul A. GARDNER 1

1 Departments of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; 2 Departments of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA


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The proximity of craniopharyngiomas to vital neurovascular structures and their high recurrence rates make them one of the most challenging brain tumors to treat. Although surgery remains the first line of therapy and offers the best chance of radical resection and oncological cure, the high recurrence tendency of craniopharyngiomas, even after apparent total removal, often makes adjuvant treatment essential. The endoscopic endonasal approach (EEA) has been recently introduced as a treatment option for both pediatric and adult craniopharyngiomas, rapidly gaining wide acceptance over the traditional transcranial approaches. Although the primary role of EEA over traditional transcranial approaches has been slowly accepted in the literature, little has been written about the limitations and potential contraindications of this approach in the treatment of craniopharyngiomas. This article presents the advantages and highlights the limitations of endoscopic transsellar/transtuberculum surgery for craniopharyngiomas. In every case, surgery should be tailored to individuals based on their age and comorbidities, presenting symptoms, tumor characteristics, prior treatment and treatment tolerance, as well as the surgeon’s preference based on personal experience and comfort.


KEY WORDS: Craniopharyngioma - Endoscopic endonasal approach - Endoscopic skull base surgery

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Publication History

Article first published online: February 23, 2018
Manuscript accepted: February 8, 2018
Manuscript received: February 1, 2018

Cite this article as

Koutourousiou M, Fernandez-Miranda JC, Wang EW, Snyderman CH, Gardner PA. Limits of transsellar/transtuberculum surgery for craniopharyngioma. J Neurosurg Sci 2018 Feb 23. DOI: 10.23736/S0390-5616.18.04376-X

Corresponding author e-mail

gardpa@upmc.edu