Clinical Analysis Of Extended Endoscopic Endonasal Approach For Craniopharyngiomas

Objective To evaluate the feasibility and safety of extended endoscopic endonasal resection of craniopharyngiomas.Methods Clinical data of 32 patients with craniopharyngiomas following extended endoscopic endonasal surgery who were admitted to the Department of Neurosurgery,The First Affiliated Hospital of Chongqing Medical University between November 2014 and May 2016 was analyzed retrospectively.The visual improvement,extent of resection and surgical complications were evaluated.Results The gross-total resection rate was 69%(22 patients),near-total resection(>95% of tumor removed)was 25%(8 patients),and subtotal resection(?80% of tumor removed)was 6%(2 patients)retrospectively.Overall,28 patients presented with visual impairment.In 86%(24 patients)of them,vision improved or even normalized after surgery.Worsening of the anterior pituitary function was reported in 53%(17 patients)of patients overall,and there were 12 new cases(48% of 25)of postoperative diabetes insipidus.Thirteen patients(41%)had hyposmia and 3 patients(9%)underwent severe memory loss after surgery.CSF leakage and secondary meningitis occurred in one patient(3%)postoperatively.One patient(3%)had brainstem hemorrhage after surgery.No patient recurred by MRI reexamination,and one patient died,with a mean follow-up duration of 10 months(range,4-22 months;SD,12 months).Conclusion The extended endoscopic endonasal approach for craniopharyngiomas is safe and feasible.It provides high extent of tumor resection and minimally invasive.However,further damage for hypothalamic-pituitary axis still exists,so preservation of endocrine function during the surgical management for craniopharyngioma still deserves continuous concern.