Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum

Surgeons must weigh the risks of aggressive resection against the long-term challenges of recurrence

Amin B. Kassam; Paul A. Gardner; Carl H. Snyderman; Ricardo L. Carrau; Arlan H. Mintz; Daniel M. Prevedello

2008

Scholarcy highlights

  • Surgeons must weigh the risks of aggressive resection against the long-term challenges of recurrence
  • The authors explain the techniques and approach used for the endoscopic endonasal resection of suprasellar craniopharyngiomas and introduce a tumor classification scheme
  • The techniques and approach used for the endoscopic, endonasal resection of suprasellar craniopharyngiomas is explained, including the introduction of a tumor classification scheme
  • The classification scheme divides tumors according to their suprasellar extension: Type I is preinfundibular; Type II is transinfundibular; Type III is retroinfundibular, extending behind the gland and stalk, and has 2 subdivisions; and Type IV is isolated to the third ventricle and/or optic recess and is not accessible via an endonasal approach
  • The endoscopic expanded endonasal approach requires a thorough understanding of both sinus and skull base anatomy
  • In its application for craniopharyngiomas, an understanding of tumor growth and extension with respect to the optic chiasm and infundibulum is critical to safely approach the lesion via an endonasal route

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