The Microsurgical Management of Giant Craniopharyngiomas

Aim:Combining the skull base approach, to raise the removal degree and to improve the postoperative results of the giant craniopharyngiomas protruding from the suprasellar region into the third ventricle and basal cistern . Methods:37 patients with giant craniopharyngiomas within the third ventricle and basal cistern were microsurgically operated by different approach in our group. Results:Total removal of the lesion was achieved in 35 cases, subtotal in 2. The pituitary stalks were reserved in 31 cases. All patients were suffered from temporary diabetes insipidus. 10 patients have transient oculomotor never palsy. Follow-up duration was 3 years and one case recurred. Conclusion:The suitable approach can be used for the operation of large craniopharyngiomas protruding from the suprasellar region into the third and basal cistern, and the approach can open a larger volume of access to the surgeon. It can achieve better exposure of basal structures (such as the optic nerve, the hypothalamus and its perforating arteries, the floor of the third ventricle, etc) with less brain and cranial nerve retraction. These approaches are safe and efficient with low incidence of postoperative complications.