The Preoperative Neuroimaging Evaluation And The Proper Approach Of Craniopharyngiomas

Objective:To sum up the microsurgical experience for treating craniopharyn-giomas, as well as the prevention and healing for the complications.Method:The clinical data of 80 cases of craniopharyngiomas were retrospectively analyzed.43(53.8%)patients were male and 37(46.2%) female. 56(70.0%) patients were older than 15 years(mean age,36.2 years), and 24(30.0%) patients were younger than 15 years(mean age,9.4years).The tumor size varied in diameter from 2.5cm to 8.5cm(mean diameter,4.5cm).Pterional approach was performed in 48 (60.0%) cases, the laminal terminal through frontbasal interhemisph-eric approach in 16(20%) cases, the subfrontal approach in 11(13.75%) cases,and the transcallosum approach into the anterior third ventricle was performed in 5(6.25%)cases.Results:Total resection 46 cases (57.5%), subtotal resection 20 cases (25.0%), and partial resectionl4 cases (17.5%). The pituitary stalk was preserved in 51 cases (63.75%), severed in 10cases(12.5%), and unidentified inl9cases(23.75%). After operations,50 patients (62.5%) complicated with diabetes insipidus, hypernatr-Emia or hyponatremia 50 cases(62.5%),9(11.25%) with high fever,8 (8.75%) with sphenoidal cerebrospinal fluid rhinorrhea, and 6 (7.5%) with asepticemeningitis.Conclusion:It is essential to perform the preoperative neuroimaging evaluation of the relations between the third ventricle, the pituitary and the optic chiasma. Choosing the proper approach can lead to a good result of the resection of the tumor and the lower recurrence rate of the complications.