Summary
The results of transnasal-transsphenoidal surgery in 31 patients with craniopharyngioma are evaluated. To assess the value of transnasal surgery in cases with visual impairment, the results are compared to cases operated transcranially. There was only one death occurred on the 5th postoperative day. Two patients developed rhinoliquorrhoea, and one a transient oculomotor palsy. Recurrences leading to re-operation occurred frequently after mere cyst aspiration and only once after subtotal tumour removal. Normal glandotrope functions of the hypophysis were preserved in 75%, disturbed functions were normalized in 19% of primary transnasal surgery. Visual disturbances were normalized or improved in 94% cases after transnasal surgery, whereas an improvement was observed in only 65% after transcranial surgery. A deterioration never appeared after transnasal surgery, but in 26% after transcranial operations.
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Andler W, Roosen K, Clar HE (1979) Pre- and postoperative evaluation of hypothalamo-pituitary function in children with craniopharyngiomas. Acta Neurochir (Wien) 45: 287–299
Artero JMC, Crespo JV, Zabalgoitia GB (1984) Status of vision following surgical treatment of craniopharyngiomas. Acta Neurochir (Wien) 73: 165–177
Baum Newman C, Levine LS, New MI (1981) Endocrine function in children with intrasellar and suprasellar neoplasms. Am J Dis Child 135: 259–262
Citrić IS, Cozzens JW (1980) Craniopharyngiomas: Transsphenoidal method of approachfor the virtuoso only? In: Clinical neurosurgery (Proceedings of the congress of neurological surgeons). Williams & Wilkins, Baltimore London, pp 169–187
Garcia-Uria J (1978) Surgical experience with craniopharyngioma in adults. Surg Neurol 9: 11–14
Grant DB, Lyen K (1982) Hypopituitarism after surgery for craniopharyngioma. Childs Brain 9: 201–204
Grisoli F, Vincentelli F, Farnarier P, Gondim-Oliveira J, Vigouroux RP (1982) Trans-sphenoidal microsurgery in the management of non-pituitary tumours of the sella turcica. In: Brock M (ed) Modern neurosurgery 1. Springer, Berlin Heidelberg New York, pp 193–204
Hamlin H (1967) Discussion: The treatment of craniopharyngiomas (Leksell L, Backlund E-O). Acta Neurol Scand. 43: 240
Hardy J, Vezina JL (1976) Transsphenoidal neurosurgery of intracranial neoplasm. In: Thompson RA, Green JR (eds) Advances in neurology, vol 15. Raven Press, New York, pp 261–274
Hoffman HJ, Hendrick EB, Humphreys RP, Buncic JR, Armstrong DL, Jenkin RDT (1977) Management of craniopharyngioma in children. J Neurosurg 47: 218–227
Konovalov AN (1981) Operative management of craniopharyngiomas. In: Krayenbühl H,et al. (eds) Advances and technical standards in neurosurgery, vol 8. Springer, Wien New York, pp 281–318
Laws ER, Trautmann JC, Hollenhorst Jr, RW (1977) Transsphenoidal decompression of the optic nerve and chiasm. Visual results in 62 patients. J Neurosurg 46: 717–722
Laws ER (1980) Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52: 661–666
Lindgren E, di Chiro G (1951) Suprasellar tumours with calcification. Acta Radiol 36: 173–195
Lüdecke DK (1982) Behandlung der Hypophysentumoren. In: Nieschlag E (ed) Endokrinologische Therapie in der Reproduktionsmedizin. Deutscher ärzte-Verlag, pp 89–119
Lyen KR, Grant DB (1982) Endocrine function, morbidity, and mortality after surgery for craniopharyngioma. Arch Dis Child 57: 837–841
Northfield DWC (1957) Rathke-pouch tumours. Brain 80: 293–311
Pertuiset B, Craniopharyngiomas. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 18. North-Holland Publishing Company, Oxford, American Elsevier Publishing Co, Inc, New York, pp 531–572
Raimondi AJ, Rougerie J (1983) A critical review of personal experiences with craniopharyngioma: Clinical history, surgical technique and operative results. In: Raimondi AJ (ed) Concepts in pediatric neurosurgery 3. S. Karger, Basel München Paris London New York Tokyo Sydney, pp 1–34
Resch R, Haas H, Schwarz S, Mayr U, Twerdy K, Hüttenberger H (1981) Kraniopharyngeom. Erfahrungen mit der Kombination von Operation und Bestrahlung sowie Probleme der hormonellen Substitution. Dtsch Med Wochenschr 106: 1502–1508
Rougerie J (1974) Intrasellar and suprasellar tumors of the infant and adolescent. In: Bushe K-A, Spoerri O, Shaw J (eds) Progress in pediatric neurosurgery. Hippokrates, Stuttgart, pp 34–45
Shapiro K, Till K, Grant DN (1979) Craniopharyngiomas in childhood. A rational approach to treatment. J Neurosurg 50: 617–623
Stahnke N, Grubel G, Lagenstein I, Willig RP (1984) Long-term follow-up of children with craniopharyngioma. Eur J Pediatr 142: 179–185
Takahashi T, Fujii H, Toba Y, Isayama Y, Tamaki N, Matsumoto S (1983) Craniopharyngioma—analysis of surgical procedure. Jpn J Ophthalmol 27: 380–386
Thomsett MJ, Conte FA, Kaplan SL, Grumbach MM (1980) Endocrine and neurologic outcome in childhood craniopharyngioma: review of effect of treatment in 42 patients. J Pediat 97: 728–735
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Dedicated to Prof. Dr. Friedrich Loew on the occasion of his 65th birthday and the 25th anniversary of the Homburg Neurosurgical University Clinic, which has been founded and built up by him.
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König, A., Lüdecke, D.K. & Herrmann, H.D. Transnasal surgery in the treatment of craniopharyngiomas. Acta neurochir 83, 1–7 (1986). https://doi.org/10.1007/BF01420500
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DOI: https://doi.org/10.1007/BF01420500