Summary Tumors such as pituitary tumors, craniopharyngiomas, midline meningiomas, or a Rathke cleft cyst causing symptoms from mass effect (vision loss, pituitary or hypothalamic dysfunction) all require surgical decompression and/or resection.
This surgery aimes at removing the craniopharyngioma which shall help in decreasing the disabling signs and symptoms. Craniotomy is common and traditional procedure to access the tumor and remove as much tumor as possible and safe.
A determining factor in the approach - Size of sella - Degree of its minerallisation - Pneumatisation of the sphenoid sinus - Position and tortuisity of carotid arteries - Presence / directions of intracranial extensions - Uncertainty about pathology of tumor - Prior therapy
Type of Approach Standard Transsphenoidal approach - Endonasal submucosal transseptal transsphenoidal approach - Endonasal submucosal septal pushover approach - Sublabial transseptal transsphenoidal approach - Endoscopic transsphenoidal approach