2025 Poster Presentations
P297: NAVIGATING THE CHALLENGE: ENDOSCOPIC ENDONASAL APPROACH TO INTRAVENTRICULAR CRANIOPHARYNGIOMA - A TECHNICAL NOTE ON OVERCOMING LIMITATIONS IN SELECTED CASES
Raywat Noiphithak, MD1; Juan Carlos Yanez-Siller, MD, MPH2; 1Department of Surgery, Division of Neurosurgery, Thammasat University; 2Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology & Skull Base Surgery, Northwestern University
Intraventricular craniopharyngiomas are a rare type of tumor and pose a formidable challenge to skull base surgeons due to their deep-seated location. Successfully managing these tumors requires navigating through intricate anatomical pathways. Traditionally, transcranial approaches have been pivotal in accessing these lesions.
Advancements in endoscopic technology and instrumentation have paved the way for the endoscopic endonasal approach (EEA). While EEA has become increasingly popular for most craniopharyngioma subtypes, its application in intraventricular cases has been considered a major limitation and often necessitates complementary transcranial techniques for optimal lesion resection. Nevertheless, in carefully selected cases, EEA alone can achieve favorable outcomes in managing intraventricular craniopharyngiomas.
In this technical note, we outline our approach to tackling intraventricular craniopharyngiomas, encompassing detailed patient selection criteria, a thorough description of our endoscopic endonasal technique, and a visual demonstration through video documentation. By integrating these elements, we aim to provide insights and strategies that enhance their surgical management. Herein, we demonstrate that in well selected cases EEA can be readily employed as standalone approach for management of these challenging tumors.