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Complications of endoscopic endonasal transsphenoidal approach for management of craniopharyngiomas

Abstract

Introduction: Craniopharyngiomas have been classically removed by various transcranial approaches (craniotomy). Nowadays with the advance in endoscope transsphenoidal surgery, the extended transsphenoidal approach is the best choice for removal of suprasellar tumors and even intra-ventricular craniopharyngiomas. However, this is still challenging to surgeons in removing the tumors by this approach and the surgical complications could be occurred.

Material and Methods: From 7/2013 – 7/2017, 50 patients (39 adults and 11 children) underwent surgery for craniopharyngioma by nasal transsphenoidal approaches. The complications regarding the surgery was recorded.
Results: The early postoperative mortality was 2/50 (4%) caused by meningitis, intra-ventricular hemorrhage. The epidural hematoma was 1/50 (2%); Meningitis 6/50 (12%); Cerebrospinal fluid (CSF) leakage occurred in 3/50 (6%); Hypothalamus damage was 1/50 (2%), Visual deterioration was 3/50 (6%) Conclusion: Almost Craniopharyngioma have been removed successfully by endoscope transsphenoidal surgery. However, still the surgical complication rate was related high such as meningitis, visual deterioration, CFS leakage and postoperative mortality rate recorded.