Microsurgical resection of cranio-pharyngioma in third ventricle with pterional approach transterminal lamina

Aim: To investigate the effective method of micro-surgical management of craniopharyngioma in third ventricle. Meth-ods: Pteriomal approach was Performed in all ten patients with craniopharyngioma in third ventricle, slyvian fissure cistern and cisterns surrounding sellar region were dissected thoroughly under surgical microscope, cerebrospinal fluid (CSF) was gradually suctioned as much us possible to attenuate the cerebral pressure and facilitate the exposure of structure around sellar region. It was found that space I stenosis, optic chiasm praevia .No tumor signs was found in space Ⅱ and Ⅲ , at the same time the terminal lamina looked like disten-tion and satiation .Therefore terminal lamina cistern was dissected, terminal lamina was incised for attempting to resect tumor in third ventricle trans terminal lamina. Results: Nine in ten patients cranio-pharyngiomas were total removed, The remaining one patient's tumor was subtotal removed for whose tumor was severly calcified, and tightly adhered to the bottom of the third ventricle. One Patient died from the postoperative epilepsy, diabetes insipidus and electrolyte disturbance, The remaining nine patients had an uneventful postoperative course, and were followed up for one half to three years, on signs of tumor recurrence were found. Conclusion: Translamina terminals approach is an effective means for successfully removal craniopharyngioma of the third ventricle type. Microsurgical technique, gentle operation and protection neural structure around sellar region and perforating artery of hypothalomus from demaging are important to decreasing the postoperative complications' morbidity.