Abstract
Introduction
The pineal region is a challenging area for neurosurgeons due to its innate anatomical features, such as its deep location, surrounding large draining veins, and adjacent critical neural structures.
Discussion
There is a high proportion of malignant tumors in the pineal gland, especially in children, and they are frequently accompanied by obstructive hydrocephalus. These cases require that surgical procedures can make a pathological diagnosis to guide further treatment strategies and immediately resolve increased intracranial pressure. Simultaneous endoscopic third ventriculostomy and biopsy have been regarded as the first-line surgical intervention before establishing a definite treatment plan. However, it is not always successful because various factors affect the surgical procedures, such as the location and extent of the tumor, degree of ventriculomegaly, location and size of the massa intermedia, and size of the foramen of Monro.
Conclusion
Here, we briefly reviewed the points to be considered in endoscopic biopsy of pineal tumors and introduced an alternative surgical procedure, the endoscopic endonasal trans-tuber cinereum approach, to surmount the anatomical hurdles.
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Yong Hwy Kim: writing manuscript, preparing the figures, organizing the paragraph, reviewing the manuscript, and electric submission. Ji Hoon Phi: writing manuscript, preparing the figures, organizing the paragraph, reviewing the manuscript. Seung-Ki Kim: concept and review of the manuscript. Kyu-Chang Wang: concept and review of the manuscript.
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Kim, Y.H., Phi, J.H., Kim, SK. et al. Endoscopic biopsy of pineal tumors: two burr hole trans-foramen of Monro approach and endonasal trans-tuber cinereum approach. Childs Nerv Syst 39, 2367–2375 (2023). https://doi.org/10.1007/s00381-022-05654-w
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DOI: https://doi.org/10.1007/s00381-022-05654-w