Abstract
Purpose
Pediatric intraventricular tumors of the third ventricle are among the most difficult-to-treat brain tumors. Recently, endonasal endoscopic surgery for suprasellar, third ventricle, and median clivus lesions has become the common procedure, and its indications are expanding to pediatric cases. We describe our strategy for endonasal endoscopic surgery for pediatric third ventricle tumors.
Method
We report on surgical anatomies and our surgical procedures in detail, including case presentations.
Result
Endoscopic endonasal surgery has the advantage of providing a wider view of the tumor site, hypothalamus, optic chiasm, and other critical structures. Good indications for the endoscopic endonasal approach for intra-third ventricular tumors are those arising from the floor of the third ventricle. In particular, craniopharyngioma, a typical pediatric suprasellar tumor, sometimes extends into the third ventricle, causing great operative difficulty. However, aggressive removal for long-term control while preserving memory and visual function is important. We perform surgery with a strategy of radically removing tumors without causing damage to visual or brain function, and we adopt the “4-hands technique by two neurosurgeons” in full endoscopic surgery to remove tumors safely and aggressively.
Conclusion
We describe our strategy for endonasal endoscopic surgery for pediatric third ventricle tumors, especially those extending from the suprasellar region into the third ventricle, and present a representative case.
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All authors contributed to this study’s conception and surgery. YT took the lead in writing the manuscript. All authors provided critical feedback and helped shape the research, analysis, and manuscript.
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This study has been approved by the research ethics committee of Osaka Metropolitan University (No. 2020–098).
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Informed consent was obtained from the parents.
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The authors declare no competing interests.
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Tanoue, Y., Morisako, H., Sasaki, T. et al. Endoscopic endonasal approach to remove pediatric intraventricular tumors of the third ventricle. Childs Nerv Syst 39, 3397–3406 (2023). https://doi.org/10.1007/s00381-023-05989-y
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DOI: https://doi.org/10.1007/s00381-023-05989-y