Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions

• DOI: 10.3171/jns.2007.106.3.400
• Publication Date: 2008-01-24T12:47:56Z
• Authors: Ilya Laufer; Vijay K. Anand; Theodore H. Schwartz
• Keywords: Tuberculum sellae; Sella turcica; Craniopharyngioma; Pituitary stalk; Cerebrospinal fluid leak; Transsphenoidal surgery

The extended transsphenoidal approach is a less invasive method for removing purely suprasellar lesions compared with traditional transcranial approaches. Most advocates have used sublabial incision and microscope reported significant risk of cerebrospinal fluid (CSF) leakage. authors report on series endoscopic endonasal surgeries resection supradiaphragmatic above normal-sized sella turcica low CSF leakage.A was to remove in 10 patients. Five were prechiasmal (three tuberculum sellae two planum sphenoidale meningiomas) five post-chiasmal (four craniopharyngiomas one Rathke cleft cyst). floor the reconstructed using multilayer closure autologous synthetic materials. Spinal drainage performed only cases. Complete achieved all but patient. pituitary stalk preserved patient, whose invaded by craniopharyngioma who had preoperative diabetes insipidus (DI). Vision improved postoperatively patients impairment. Six temporary DI; five, DI became permanent. Four required cortisone thyroid replacement. After mean follow up months, there transient leak when lumbar drain clamped prematurely postoperative Day 5.A feasible minimally alternative craniotomy. With closure, leakage can be avoided. A larger will validate this approach.