2025 Poster Presentations
P173: EARLY EXPERIENCE OF ENDOSCOPIC ENDONASAL APPROACH FOR CRANIOPHARYNGIOMAS AND COMPARISON WITH SUPRAORBITAL KEYHOLE APPROACH: A CASE SERIES
Youngbeom Seo1; Yoon-Hee Choo2; 1Yeungnam University Hospital; 2Seoul St.Mary's Hostpital, The catholic University of Korea
Objective: The endoscopic endonasal approach (EEA) has become one of the best surgical methods for treatment of craniopharyngiomas which located in the sellar or suprasellar region. Here, we present our early experience of EEA and compared with results of supraorbital keyhole approach.
Methods: Between 2021 and 2023, a total of 8 patients underwent surgical resection for craniopharyngiomas. Five patients underwent surgical resections using the EEA. The supraorbital keyhole approach was used in 3 patients. We retrospectively reviewed clinical and surgical outcomes in the first consecutive five patients with newly diagnosed craniopharyngioma compared with results of supraorbital keyhole approach. This cohort study comprised 7 male and 1 female patients. The median age was 47.5 years (range, 8-69).
Results: Gross total removal was performed in 6 of the 8 patients and subtotal tumor removal in 2 patients. GTR was achieved in 1 out of 3 patients in Supraorbital approach and in 3 out of 5 patients in EEA. In Supraorbital approach, the mean operation time was 226 minutes, whereas in EEA, it was 277 minutes. The mean tumor sizes were 22 mm and 29 mm, respectively. Visual function improved in 6 of 6 patients. Endocrine function worsened in 6 of 8 patients. The postoperative cerebrospinal fluid leakage occurred in 1 patient treated with EEA. All patients retained previous quality of life.
Conclusions: The extended endoscopic endonasal and supraorbital keyhole approaches provide minimally invasive access for craniopharyngiomas. These two keyhole approaches appear to be a safe and effective treatment modality for craniopharyngiomas. The optimal approach for a particular case should be based on tumor characteristics and surgeon’s experience. A personalized, tailored approach to the individual tumor based on several factors is crucial. However, more cases and long-term follow-up outcomes are required to confirm the clinical efficacy of these keyhole approaches.