Cystic Craniopharyngioma Neuroendoscopic Catheter Placement

Though complete resection of craniopharyngioma is desirable
for lower recurrence rates, it is hindered by functional
preservation. Currently, a trend toward less radical surgical
approaches is observed. In a multicenter study of children and adolescents with craniopharyngioma, KRANIOPHARYNGEOM
2007, it was observed that the realized treatment was more
radical (p = 0.01) in patients recruited between 2001 and 2007
(38%) when compared with patients treated between 2007 and
2012 (18%).
Cystic craniopharyngiomas
present a unique challenge because of the possibility
of recurrence of cyst irrespective of the modality of initial
treatment. Almost 90% of craniopharyngiomas have a cystic
component.3 The presence of a cyst in craniopharyngioma
can account for major total bulk of the tumor, and a predominantly
cystic tumor is seen in 60% of craniopharyngiomas. The treatment of cystic craniopharyngioma in children is varied. The treatment ranges from radical excision to direct radiotherapy. As the morbidity of excision is high, more conservative approaches are used.
The traditional approach to cystic craniopharyngioma is a
variable extent of microsurgical resection. Ommaya reservoir
is often placed in the residual cyst for repeated aspiration or
intracavitary therapy. However, the malposition of reservoir
is not uncommon. In such circumstances, a neuroendoscopic
approach provides a less invasive and more accurate technique
to deal with cystic craniopharyngiomas. Since 2013, we follow
the endoscopic transventricular approach for intra- and
paraventricular cystic craniopharyngiomas.

Transventricular endoscopy is a minimally invasive treatment for cystic craniopharyngiomas. Endoscopic transventricular approach is a safe alternative for initial treatment of suprasellar cystic craniopharyngioma in children.

Konar S. Kulkarni AV, Shukla D, Mishra T, Devi BI, Peer S, Lanka V. Management options for suprasellar cystic craniopharyngioma: Endoscopic Transventricular Approach and Microsurgical Approach. J Neurosci Rural Pract 2021;12:121–127. DOI https://doi.org/10.1055/s-0041-1722839
Shukla D. Transcortical Transventricular Endoscopic Approach and Ommaya Reservoir Placement for Cystic Craniopharyngioma. Pediatr Neurosurg 2014–15;50:291–294 (DOI:10.1159/000433605)

• Category

  Craniopharyngioma - Childhood