Preservation of hypothalamic function in total removal of craniopharyngioma

Obiective To study the better method of surgical management of craniopharygioma MethodsIn 30 patienrs with craniopharyngioma,the pterional approach was performed in 28 patients, subfrontal approach in 2patients,The tumor was dissected in the parachiasmal, opticocarotic,carotidotentorial spaces and opening laminal terminals Great attention was paid to the presservation of the perforating arteries from the internal carotic,posterior andanterior communication an anterior choroidal arteries to the structure of the hypothalamus and the avoidomce of the hypothalamus injury. The solid portion of the tumor was removed with Piecemeal piecemeal after the cyst ftuid aspirated. Re-sults Total removal of the tumor were achieved in 29,patients, and subtotalremoval in one patient with secondsurgery. Follow up of all cases, 27patients had a normal life, one patient need assistance. One died from inhalation asphy xia 7 days for surgery, and other died of the complication of diabetes insipidus Conclusions.Many different surgical approaches can be used in the treatment of carniopharyngioma,according to the localization and extension Of the tumor. However, avoidance of the neural structures injury surrounding third ventricle and preservation of the perforating arteries to hypothalamus could be the key to achieve a good surgical result