Suprachiasmatic translamina terminalis corridor used in endoscopic endonasal approach for resecting third ventricular craniopharyngioma

J Neurosurg. 2015 May;122(5):1166-72. doi: 10.3171/2015.1.JNS132842. Epub 2015 Feb 27.

Abstract

Object: The translamina terminalis corridor was used in the transcranial anterior route to treat third ventricular craniopharyngioma (TVC), which presents a challenge to neurosurgeons. The endoscopic endonasal approach (EEA) has recently been used to treat craniopharyngiomas. However, there are few reports of the EEA being used to treat TVC. The authors' novel surgical approach of treating selected TVC by the endoscopic endonasal route via the suprachiasmatic translamina terminalis (STLT) corridor is described.

Methods: In this single-center study, the EEA via the STLT corridor was used to resect TVC with great upper and anterior extension causing bulged lamina terminalis, and TVC with a residual upper compartment, after routine infrachiasmatic transmetastalk corridor resection.

Results: The STLT corridor was used in 3 patients. Gross-total resection was achieved in all cases. One patient achieved visual improvement, and the other 2 patients showed partial visual improvement. Leakage of CSF occurred in 1 patient. Postoperative hormone replacement therapy was required in all patients.

Conclusions: The STLT corridor is a complementary minimally invasive corridor used in the EEA for treating selected TVC. The STLT alone or combined with infrachiasmatic transmetastalk corridors should be selected depending on the size of suprachiasmatic and infrachiasmatic space.

Keywords: EEA = endoscopic endonasal approach; GTR = gross-total resection; ITMS = infrachiasmatic transmetastalk; LT = lamina terminalis; OC = optic chiasm; PS = pituitary stalk; SIS = superior intercavernous sinus; STLT = suprachiasmatic translamina terminalis; TLT = translamina terminalis; TVC = third ventricular craniopharyngioma; TVF = third ventricle floor; craniopharyngioma; endoscopic endonasal approach; lamina terminalis; surgical technique; third ventricle.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Neoplasms / surgery*
  • Craniopharyngioma / surgery*
  • Female
  • Humans
  • Male
  • Neuroendoscopy / methods*
  • Nose
  • Third Ventricle*