Comparative Analysis Of Extend Endoscopic Endonasal And Open Transcranial Resection Of Craniopharyngiomas

Objective: To compare the efficacy and complications of the extend endoscopic endonasal approach(EEA)and open transcranial approach for resection of craniopharyngiomas.Methods: 46 patients with craniopharyngiomas who underwent extend EEA and 54 patients who underwent transcranial route in our department were analyzed retrospectively.The gross total resection(GTR)rate,length of hospital stays and complications of the two groups were compared.Results: The tumor diameters of the endoscopic group were longer than the transcranial group(3.5±1.3cm vs.3.0±0.8cm,P<0.05).The endoscopic group had a greater GTR rate(67.4% vs.46.3%,P<0.05)and improved visual outcome(84.2% vs.59.5%,P<0.05),but lower rate of hypopituitarism(56.5% vs.75.9%,P<0.05)and new permanent diabetes insipidus(51.4% vs.72.7%,P<0.05).On the contrast,the endoscopic group had a greater rate of cerebrospinal fluid leak(4.3% vs.0.0%,P>0.05)and longer hospital stays(17.0±3.6d vs.13.1±2.3d,P<0.01).Hyposmia(34.8%)and hemorrhinia(2.2%)only happened in the endoscopic group.Conclusions: Compared with transcranial route,the extend EEA for craniopharyngiomas is minimal invasion and effective,which can effectively improve the GTR rate and relief the clinical symptoms.