Endoscopic Endonasal Approach for Resection of a Pediatric Craniopharyngioma: Operative Video and Technical Nuances

James K. Liu; Jean Anderson Eloy

doi:10.1055/s-0038-1626707

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

CC-BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2018; 79(S 03): S245-S246
DOI: 10.1055/s-0038-1626707

Skull Base: Operative Videos

Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Endonasal Approach for Resection of a Pediatric Craniopharyngioma: Operative Video and Technical Nuances

James K. Liu

¹Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark, New Jersey, United States

²Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark, New Jersey, United States

,

Jean Anderson Eloy

¹Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark, New Jersey, United States

²Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark, New Jersey, United States

⁴Department of Ophthalmology and Visual Science, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark, New Jersey, United States

› Author Affiliations

Abstract

We present a pediatric case of a retrochiasmatic craniopharyngioma in the suprasellar region with third ventricular extension that was resected through a purely endoscopic endonasal approach (EEA) via the transplanum transtuberculum corridor. The patient is a 12-year-old boy who presented with progressive visual loss and panhypopituitarism. The EEA allows direct visualization of the undersurface of the optic chiasm and hypothalamus so that safe and meticulous tumor dissection can be performed to preserve these critical neurovascular structures. This video atlas demonstrates the operative technique and surgical nuances of the endoscopic skull base approach, microdissection of the tumor from the critical neurovascular structures, and multilayered reconstruction of the skull base defect with a nasoseptal flap. A gross total resection was achieved, and the patient was neurologically intact with improved visual acuity and visual fields. In summary, the EEA via the transplanum transtuberculum corridor is an important strategy in the armamentarium for surgical management of pediatric craniopharyngiomas.

The link to the video can be found at: https://youtu.be/bmgO_PMRHPk.

Keywords

endoscopic endonasal approach - craniopharyngioma - pediatric skull base surgery - suprasellar tumor

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