Skip to main content
SpringerLink
Log in

Cranial Surgery for Adult Craniopharyngiomas: Techniques and Indications

  • Chapter
  • First Online:
Adult Craniopharyngiomas

  • 370 Accesses

Abstract

Since the development of endonasal endoscopic techniques and due to their sellar-suprasellar location, most adult onset craniopharyngiomas (AO-CP) are approached ventrally from the nose.

When the tumor extends laterally, anteriorly, or is located purely inside the third ventricle, cranial approaches must be used.

This chapter will focus on indications and technical aspects for surgeons with operative and anatomical data for specific trans-lamina terminalis, trans-frontal, and trans-callosal surgical approaches.

Lastly, a literature review on specific situations such as management of cyst craniopharyngiomas will be included.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AC V:

Anterior choroidal vein

ACA1:

First segment of the cerebral artery

AChA:

Anterior choroidal artery

ACoA:

Anterior communicating artery

AO-CP:

Adult onset craniopharyngiomas

CCPs:

Cystic craniopharyngiomas

Ch:

Chiasm

ChP:

Choroid plexus

FL:

Frontal lobe

GTR:

Gross total removal

hS V:

Thalamostriate vein

HW:

Hypothalamic walls

IC V:

Internal cerebral vein

ICA:

Internal carotid

III V:

Third ventricle

LT:

Lamina terminalis

MBA:

Mammillary body angle

MF:

Foramen of Monro

ON:

Optic nerve

PG:

Pituitary gland

PS:

Pituitary stalk

RXT:

Radiotherapy

SF:

Sylvian fissure

STR:

Subtotal removal

TC:

Trans-callosal approach

TF:

Trans-frontal approach

Th:

Thalamus

TL:

Temporal lobe

TLT:

Trans-lamina terminalis approach

References

  1. Dandurand C, Sepehry AA, Asadi Lari MH, Akagami R, Gooderham P. Adult craniopharyngioma: case series, systematic review, and meta-analysis. Neurosurgery. 2018;83(4):631–41. https://doi.org/10.1093/neuros/nyx570.

    Article  PubMed  Google Scholar 

  2. Apra C, Enasceschu C, Lapras V, Raverot G, Jouanneau E. Is gross total resection reasonable in adults with craniopharyngiomas with hypothalamic involvement ? World Neurosurg. 2019; https://doi.org/10.1016/j.wneu.2019.06.037.

  3. de Divitiis E, Cappabianca P, Cavallo LM, Esposito F, de Divitiis O, Messina A. Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas. Neurosurgery. 2007;61(5 Suppl 2):219–27; discussion 228. https://doi.org/10.1227/01.neu.0000303220.55393.73.

    Article  PubMed  Google Scholar 

  4. Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg. 2008;108(4):715–28. https://doi.org/10.3171/JNS/2008/108/4/0715.

    Article  PubMed  Google Scholar 

  5. Cappabianca P, Cavallo LM, Colao A, et al. Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invasive Neurosurg. 2002;45(4):193–200. https://doi.org/10.1055/s-2002-36197.

    Article  CAS  PubMed  Google Scholar 

  6. Komotar RJ, Starke RM, Raper DMS, Anand VK, Schwartz TH. Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas. World Neurosurg. 2012;77(2):329–41. https://doi.org/10.1016/j.wneu.2011.07.011.

    Article  PubMed  Google Scholar 

  7. Kassam AB, Prevedello DM, Thomas A, et al. Endoscopic endonasal pituitary transposition for a transdorsum sellae approach to the interpeduncular cistern. Neurosurgery. 2008;62(3 Suppl 1):57–72; discussion 72-74. https://doi.org/10.1227/01.neu.0000317374.30443.23.

    Article  PubMed  Google Scholar 

  8. Nanda A, Narayan V, Mohammed N, Savardekar AR, Patra DP. Microsurgical resection of suprasellar craniopharyngioma-technical purview. J Neurol Surg Part B Skull Base. 2018;79(Suppl 3):S247–8. https://doi.org/10.1055/s-0038-1625941.

    Article  Google Scholar 

  9. Prieto R, Pascual JM. Norman M. Dott, master of hypothalamic craniopharyngioma surgery: the decisive mentoring of Harvey Cushing and Percival Bailey at Peter Bent Brigham Hospital. J Neurosurg. 2017;127(4):927–40. https://doi.org/10.3171/2016.9.JNS16702.

    Article  PubMed  Google Scholar 

  10. Dehdashti AR, de Tribolet N. Frontobasal interhemispheric trans-lamina terminalis approach for suprasellar lesions. Neurosurgery. 2005;56(2 Suppl):418–24.; discussion 418-424. https://doi.org/10.1227/01.neu.0000157027.80293.c7.

    Article  PubMed  Google Scholar 

  11. Choudhri O, Chang SD. Subfrontal trans-lamina terminalis approach to a third ventricular craniopharyngioma. Neurosurg Focus. 2016;40 Video Suppl 1:2016.1.FocusVid.15416. https://doi.org/10.3171/2016.1.FocusVid.15416

  12. Silva PS, Cerejo A, Polónia P, Pereira J, Vaz R. Trans-lamina terminalis approach for third ventricle and suprasellar tumours. Clin Neurol Neurosurg. 2013;115(9):1745–52. https://doi.org/10.1016/j.clineuro.2013.04.010.

    Article  PubMed  Google Scholar 

  13. Weil AG, Robert T, Alsaiari S, Obaid S, Bojanowski MW. Using the trans-lamina terminalis route via a pterional approach to resect a retrochiasmatic craniopharyngioma involving the third ventricle. Neurosurg Focus. 2016;40 Video Suppl 1:2016.1.FocusVid.15440. https://doi.org/10.3171/2016.1.FocusVid.15440

  14. Maira G, Anile C, Colosimo C, Cabezas D. Craniopharyngiomas of the third ventricle: trans-lamina terminalis approach. Neurosurgery. 2000;47(4):857–63.; discussion 863–865. https://doi.org/10.1097/00006123-200010000-00014.

    Article  CAS  PubMed  Google Scholar 

  15. Bozkurt B, Yağmurlu K, Belykh E, et al. Quantitative anatomic analysis of the transcallosal-transchoroidal approach and the transcallosal-subchoroidal approach to the floor of the third ventricle: an anatomic study. World Neurosurg. 2018;118:219–29. https://doi.org/10.1016/j.wneu.2018.05.126.

    Article  PubMed  Google Scholar 

  16. Rosenfeld JV, Freeman JL, Harvey AS. Operative technique: the anterior transcallosal transseptal interforniceal approach to the third ventricle and resection of hypothalamic hamartomas. J Clin Neurosci Off J Neurosurg Soc Australas. 2004;11(7):738–44. https://doi.org/10.1016/j.jocn.2004.03.008.

    Article  Google Scholar 

  17. Apps JR, Carreno G, Gonzalez-Meljem JM, et al. Tumour compartment transcriptomics demonstrates the activation of inflammatory and odontogenic programmes in human adamantinomatous craniopharyngioma and identifies the MAPK/ERK pathway as a novel therapeutic target. Acta Neuropathol (Berl). 2018;135(5):757–77. https://doi.org/10.1007/s00401-018-1830-2.

    Article  CAS  Google Scholar 

  18. Hukin J, Steinbok P, Lafay-Cousin L, et al. Intracystic bleomycin therapy for craniopharyngioma in children: the Canadian experience. Cancer. 2007;109(10):2124–31. https://doi.org/10.1002/cncr.22633.

    Article  CAS  PubMed  Google Scholar 

  19. Kilday J-P, Caldarelli M, Massimi L, et al. Intracystic interferon-alpha in pediatric craniopharyngioma patients: an international multicenter assessment on behalf of SIOPE and ISPN. Neuro-Oncology. 2017;19(10):1398–407. https://doi.org/10.1093/neuonc/nox056.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Steinbok P, Hukin J. Intracystic treatments for craniopharyngioma. Neurosurg Focus. 2010;28(4):E13. https://doi.org/10.3171/2010.1.FOCUS09315.

    Article  PubMed  Google Scholar 

  21. Cavalheiro S, Dastoli PA, Silva NS, Toledo S, Lederman H, da Silva MC. Use of interferon alpha in intratumoral chemotherapy for cystic craniopharyngioma. Childs Nerv Syst ChNS Off J Int Soc Pediatr Neurosurg. 2005;21(8–9):719–24. https://doi.org/10.1007/s00381-005-1226-1.

    Article  CAS  Google Scholar 

  22. Cavalheiro S. Intracystic interferon-alpha in pediatric craniopharyngioma patients. Neuro-Oncology. 2017;19(10):1419. https://doi.org/10.1093/neuonc/nox123.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Moussa AH, Kerasha AA, Mahmoud ME. Surprising outcome of Ommaya reservoir in treating cystic craniopharyngioma: a retrospective study. Br J Neurosurg. 2013;27(3):370–3. https://doi.org/10.3109/02688697.2012.741732.

    Article  CAS  PubMed  Google Scholar 

  24. Spaziante R, De Divitiis E, Irace C, Cappabianca P, Caputi F. Management of primary or recurring grossly cystic craniopharyngiomas by means of draining systems. Topic review and 6 case reports. Acta Neurochir (Wien). 1989;97(3–4):95–106.

    Article  CAS  Google Scholar 

  25. Lauretti L, Legninda Sop FY, Pallini R, Fernandez E, D’Alessandris QG. Neuroendoscopic treatment of cystic craniopharyngiomas: a case series with systematic review of the literature. World Neurosurg. 2018;110:e367–73. https://doi.org/10.1016/j.wneu.2017.11.004.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pituitary and Skull Base Neurosurgical Department, Neurological Hospital, Hospices Civils de Lyon, Lyon, France

    E. Jouanneau & R. Manet

  2. Claude Bernard University Lyon 1, Lyon, France

    E. Jouanneau

  3. Neurosurgical Department, La Timone Hospital, Marseille, France

    H. Dufour

Authors
  1. E. Jouanneau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Dufour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Manet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Jouanneau .

Editor information

Editors and Affiliations

  1. Skull Base and Pituitary Neurosurgical Department, Hôpital Pierre Wertheimer “Groupement Hospitalier Est” Hospices Civils de Lyon“Claude Bernard” Lyon 1 University, Lyon, France

    Emmanuel Jouanneau

  2. Endocrinology Department, Reference Center for Rare Pituitary Diseases HYPO“Groupement Hospitalier Est” Hospices Civils de Lyon“Claude Bernard” Lyon 1 University, Lyon, France

    Gérald Raverot

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Jouanneau, E., Dufour, H., Manet, R. (2020). Cranial Surgery for Adult Craniopharyngiomas: Techniques and Indications. In: Jouanneau, E., Raverot, G. (eds) Adult Craniopharyngiomas. Springer, Cham. https://doi.org/10.1007/978-3-030-41176-3_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-41176-3_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-41175-6

  • Online ISBN: 978-3-030-41176-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation