Purely Neuro-endoscopic Transventricular Approach for Cystic Craniopharyngiomas

Background and Importance: Craniopharyngiomas are tumors made up of mixed components which can present intraventricular cystic portion. This study aimed at evaluating the outcome of endoscopic marsupialization as a surgical approach. Methods and Materials/Patients: We report ۱۱ cases presenting craniopharyngioma with intraventricular cystic portion inducing hydrocephalus managed at Neurosurgery Unit of Fann Hospital between June ۲۰۱۳ and June ۲۰۱۷. Endoscopic marsupialization was realized for all patients with a rigid neuroendoscope Karl Storz. Results: The mean age of cases was ۳۰.۱۸ years with a range of ۰۷ to ۶۹ years. There was a male predominance with a sex ratio of ۱.۷۵. All patients were suffering from intracranial pressure syndrome. Lowering visual acuate including two (۰۲) blindness cases was found in patients under ۱۵ years. Frontal lobe syndrome was found in all patients of more than ۵۰ years. A cerebral CT scan was realized for ۹ patients and an MRI for ۴ patients. A cystic marsupialization with biopsy was realized by precoronal approach. Fluid looked like « waste oil » for ۹ patients. Ventriculocisternostomy of the ۳rd ventricle was realized in ۲ cases. Progress was favorable with intracranial pressure signs disappearance in ۸ cases. We noticed ۳ failures with cyst persistence at control CT-Scan. Three patients had a recurrence, requiring revised marsupialization complicated by death in ۱ case. Conclusion: Endoscopic marsupialization represents a seductive technique which is easy and reproducible in the therapeutic procedure of intraventricular cystic craniopharyngioma.

کلیدواژه ها:

Craniopharyngioma ، Endoscopic marsupialization ، Intraventricular cyst