Jung Geena, Cohen Joshua M, Oriko David, Buckner-Wolfson Emery, Kim Timothy, Liriano Genesis, Kobets Andrew J
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
University of Maryland Medical Center, Baltimore, MD, USA.
Childs Nerv Syst. 2025 Mar 17;41(1):131. doi: 10.1007/s00381-025-06788-3.
Craniopharyngiomas are rare tumors found in the suprasellar region of the brain. Untreated, they have the potential to cause debilitating complications, including vision loss and cognitive decline. Craniopharyngiomas can be resected through several surgical options including endoscopic endonasal (EEA) and open, transcranial approaches, cystic drainage, and ventricular neuroendoscopic approaches. Here, we seek to review the literature and compare characteristics of lesions resected by the EEA versus open approach.
A comprehensive database search was performed on PubMed, Google Scholar, and Embase using key terms. Included studies utilized both EEA and open approaches for craniopharyngioma resection.
No studies reported a significant difference in tumor location, consistency, pathology, or presence of calcification. One study reported an increased preoperative tumor volume with the open approach. The open approach was significantly associated with a longer follow-up period (4/16) and hospital length of stay (2/16), as well as a greater rate of recurrence (2/16) and mortality (1/16). New-onset diabetes insipidus (3/16) and vision deterioration (3/16) following surgery were significantly more common following an open approach.
Inherent in the surgical decision-making regarding approach are the anatomical considerations of the tumor. Through our literature search, we found tumors were not substantially different for the different approaches, consistent with our clinical experience. This may be related to the refinement of endonasal techniques, allowing larger, suprasellar tumors to be amenable to GTR more than in the past.
颅咽管瘤是一种罕见的肿瘤，位于脑的鞍上区域。若不治疗，它们有可能导致使人衰弱的并发症，包括视力丧失和认知能力下降。颅咽管瘤可以通过多种手术方式切除，包括鼻内镜下经鼻入路（EEA）、开放经颅入路、囊肿引流以及脑室神经内镜入路。在此，我们旨在回顾文献并比较经EEA入路与开放入路切除的病变特征。
使用关键词在PubMed、谷歌学术和Embase上进行了全面的数据库检索。纳入的研究同时采用了EEA和开放入路进行颅咽管瘤切除。
没有研究报告肿瘤位置、质地、病理或钙化情况存在显著差异。一项研究报告开放入路术前肿瘤体积增大。开放入路与更长的随访时间（4/16）、住院时间（2/16）显著相关，以及更高的复发率（2/16）和死亡率（1/16）。术后新发尿崩症（3/16）和视力恶化（3/16）在开放入路后明显更常见。
手术入路决策中固有的是对肿瘤的解剖学考虑。通过我们的文献检索，我们发现不同入路的肿瘤没有实质性差异，这与我们的临床经验一致。这可能与鼻内技术的改进有关，使得比过去更多的鞍上大肿瘤能够进行全切除（GTR）。
