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Trans-eyebrow supraorbital keyhole approach in suprasellar and third ventricular craniopharyngioma surgery: the experience of 27 cases and a literature review

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Abstract

Background

The trans-eyebrow supraorbital keyhole approach, a minimal transcranial approach, has been widely used in different types of surgery for sellar and parasellar lesions. In this study, we investigated the outcome of this approach in the surgical treatment of suprasellar and third ventricular craniopharyngioma.

Methods

Twenty-seven patients with suprasellar and third ventricular craniopharyngioma underwent surgery via a supraorbital approach between June 2007 and June 2018. The medical data and follow-up results were retrospectively analyzed.

Results

All tumors were located in the suprasellar region and the third ventricle. The mean tumor size was 29.1 mm. The mean follow-up period was 49.6 months. Gross total resection (GTR) was achieved in 23 patients (85.2%). Of 17 patients with preoperative visual impairment, 12 patients (70.6%) showed improvement. Following surgery, 11 patients exhibited new-onset anterior hypopituitarism, ten developed diabetes insipidus, and two became overweight. One residual tumor relapsed 1 year after surgery. No perioperative death, cerebrospinal fluid (CSF) rhinorrhea, or meningitis occurred. All patients exhibited satisfactory cosmetic results. At the last follow-up, the Extended Glasgow Outcome Scale Score was 8 in 25 patients (92.6%).

Conclusion

The supraorbital trans-eyebrow keyhole approach is characterized by minimal invasion and a satisfactory cosmetic outcome. According to our experience, craniopharyngiomas located in the suprasellar region and the third ventricle can be safely resected via a trans-eyebrow supraorbital keyhole approach.

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Funding

The funding was provide by The Science and Technology Project of Guangdong Province (NO:2015A020212016 and 2016A020214007), The Science and Technology Program of Guangzhou (NO: 201604020080), China.

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Author notes

  1. Meiqin Cai and Zhuopeng Ye have contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China

    Meiqin Cai, Zhuopeng Ye, Cong Ling, Baoyu Zhang & Bo Hou

Authors
  1. Meiqin Cai
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  2. Zhuopeng Ye
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  3. Cong Ling
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  4. Baoyu Zhang
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Correspondence to Bo Hou.

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Cai, M., Ye, Z., Ling, C. et al. Trans-eyebrow supraorbital keyhole approach in suprasellar and third ventricular craniopharyngioma surgery: the experience of 27 cases and a literature review. J Neurooncol 141, 363–371 (2019). https://doi.org/10.1007/s11060-018-03041-7

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  • DOI: https://doi.org/10.1007/s11060-018-03041-7

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