Endoscopic Endonasal Approach to Craniopharyngioma: Extent of Resection and Endocrine Outcomes
DOI:
https://doi.org/10.5281/zenodo.22310529Keywords:
Craniopharyngioma, Endoscopic endonasal approach, Gross-total resection, Hypothalamic obesity, PanhypopituitarismAbstract
Background: Craniopharyngiomas are rare, benign but locally aggressive sellar tumours, and the endoscopic endonasal approach
has become a major alternative to transcranial surgery. Objective: To review published series, comparative cohorts and meta-analyses on extent of resection and endocrine outcome after endoscopic endonasal craniopharyngioma resection. Methods: Narrative review of case series, classification schemes, comparative cohorts, and systematic reviews and meta-analyses of endoscopic versus transcranial resection. Findings: Pooled series report gross-total resection in two-thirds to over four-fifths of cases. Meta-analyses show higher resection rates and better vision endoscopically, at the cost of more cerebrospinal fluid leaks, which fall toward zero with nasoseptal flap reconstruction. Diabetes insipidus and panhypopituitarism remain common after stalk sacrifice; hypothalamic involvement,
more than approach, predicts obesity and cognitive decline. Conclusions: Endoscopic endonasal surgery gives favourable resection and visual outcomes but needs individualised, hypothalamus-sparing strategies to limit endocrine and metabolic morbidity.
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