PNA Medical Corner: Best Type of Surgery for Craniopharyingiomas

James Liu smThis month the PNA Medical Corner showcases an article co-written by PNA member James K. Liu of the Neurological Institute of New Jersey. The study examines microscopic versus endoscopic surgical approaches for craniopharyingiomas and give tips on helping surgeons decide which method to use, depending on the individual tumor’s characteristics.

 Here is the abstract:

Microscopic versus endoscopic approaches for craniopharyngiomas: choosing the optimal surgical corridor for maximizing extent of resection and complication avoidance using a personalized, tailored approach.
Liu JK, Sevak IA, Carmel PW, Eloy JA.
Neurosurg Focus. 2016 Dec;41(6):E5.

Abstract

Resection remains the mainstay of treatment for craniopharyngiomas with the goal of radical resection, if safely possible, to minimize the rate of recurrence. Endoscopic endonasal and microscopic transcranial surgical approaches have both become standard methods for the treatment for craniopharyngiomas. However, the approach selection paradigm for craniopharyngiomas is still a point of discussion. Choosing the optimal surgical approach can play a significant role in maximizing the extent of resection and surgical outcome while minimizing the risks of potential complications. Craniopharyngiomas can present with a variety of different sizes, locations, and tumor consistencies, and each individual tumor has distinct features that favor one specific approach over another. The authors review standard cranial base techniques applied to craniopharyngioma surgery, using both the endoscopic endonasal approach and traditional open microsurgical approaches, and analyze factors involved in approach selection. They discuss their philosophy of approach selection based on the location and extent of the tumor on preoperative imaging as well as the advantages and limitations of each surgical corridor, and they describe the operative nuances of each technique, using a personalized, tailored approach to the individual patient with illustrative cases and videos.

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