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Cystic Craniopharyngiomas: Endoscopic Endonasal Transsphenoidal Approach

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Midline Skull Base Surgery

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Abstract

The endoscopic transsphenoidal route provides a minimal access method by which the majority of cystic craniopharyngiomas may be approached. While this remains a technically challenging surgical technique, advances in equipment and anatomical awareness have enabled widespread adoption. It is however the degree of adhesion of the craniopharyngioma to the chiasm and hypothalamus that is the main determinant of resectability, not surgical skill. When possible, excision via the transsphenoidal route has significant advantages over transcranial surgery. The main issues specific to this technique are those of closing the skull base defect and avoiding CSF leakage. This chapter examines the pros and cons of the approach and describes our surgical technique and management strategies in these complex cases.

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Author information

Authors and Affiliations

  1. Victor Horsley Department of Neurosurgery, National Hospital, London, UK

    Neil L. Dorward MD & Antonio Biroli MD

  2. Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy

    Michelangelo de Angelis MD

Authors
  1. Neil L. Dorward MD
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  2. Antonio Biroli MD
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  3. Michelangelo de Angelis MD
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Corresponding author

Correspondence to Neil L. Dorward MD .

Editor information

Editors and Affiliations

  1. Div. of Neurosurgery Dept. of Neuroscien, University of Naples “Federico II” , Naples, Italy

    Paolo Cappabianca

  2. Div. of Neurosurgery Dept. of Neuroscien, University of Naples “Federico II” , Naples, Italy

    Luigi Maria Cavallo

  3. Div. of Neurosurgery Dept. of Neuroscien, University of Naples “Federico II” , Naples, Italy

    Oreste de Divitiis

  4. Div. of Neurosurgery Dept. of Neuroscien, University of Messina , Messina, Messina, Italy

    Felice Esposito

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Dorward, N.L., Biroli, A., de Angelis, M. (2016). Cystic Craniopharyngiomas: Endoscopic Endonasal Transsphenoidal Approach. In: Cappabianca, P., Cavallo, L., de Divitiis, O., Esposito, F. (eds) Midline Skull Base Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-21533-4_7

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  • DOI: https://doi.org/10.1007/978-3-319-21533-4_7

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21532-7

  • Online ISBN: 978-3-319-21533-4

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