Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 90 Bergen Street, Suite 8100, Newark, New Jersey 07101 , USA.
Neurosurg Focus. 2011 Apr;30(4):E14. doi: 10.3171/2011.1.FOCUS10297.
Retrochiasmatic craniopharyngiomas are challenging tumors to remove given their deep location and proximity to critical neurovascular structures. Complete surgical removal offers the best chance of cure and prevention of recurrence. The endoscopic endonasal extended transsphenoidal approach offers direct midline access to the retrochiasmatic space through a transplanum transtuberculum corridor. Excellent visualization of the undersurface of the optic chiasm and hypothalamus can be obtained to facilitate bimanual extracapsular dissection to permit complete removal of these formidable tumors. In this report the authors review the endoscopic endonasal extended transsphenoidal approach, with specific emphasis on technical operative nuances in removing retrochiasmatic craniopharyngiomas. An illustrative intraoperative video demonstrating the technique is also presented.
视交叉后颅咽管瘤由于其位置深在，毗邻重要的神经血管结构，因此切除极具挑战性。完全手术切除是治愈和预防复发的最佳机会。内镜经鼻扩大经蝶窦入路通过蝶鞍结节间池提供了直达视交叉后区的中线入路。可以获得视神经交叉和下丘脑底面的良好可视化，从而便于双手进行囊外解剖，以允许完全切除这些巨大的肿瘤。在本报告中，作者回顾了内镜经鼻扩大经蝶窦入路，特别强调了切除视交叉后颅咽管瘤的技术操作细节。还展示了一个说明性的术中视频演示该技术。
