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The Anterior Interhemispheric Transcallosal Approach in Craniopharyngiomas

Objective: Craniopharyngioma is a type of embryo-epithelium tumor which originates from the remnant tissue of Rathke’s pouch, and the tumor mostly grows in saddle. These tumors are associated with significant morbidity and mortality, primarily from their anatomic proximity to many critical neurological and vascular structures. This study aimed to summarize the clinical experiences and postoperative effects of the transcallosal approach for craniopharyngiomas. Methods: A retrospective analysis was performed on 14 consecutive patients with craniopharyngioma who underwent surgical resection via anterior transcallosal route at the department of Neurosurgery of Cherchell Hospital between January 2015 and June 2020. All patients had thorough preoperative and postoperative ophthalmological and endocrine evaluations. The follow-up period ranged from 10 to 36 months. Results: Gross total resection was achieved in eight patients (57%) in this series. Six patients (43%) with preoperative visual impairment experienced significant visual improvement. The overall recurrence rate was 36%. Conclusion: The interhemispheric transcallosal approach can be used alone for purely intraventricular craniopharyngiomas, or they can be used in combination with other anterolateral and midline transcranial approaches to respect the intra and extra ventricular portions of the tumor.