gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Comparison of transcranial and endoscopic transsphenoidal resection of craniopharyngiomas

Meeting Abstract

Search Medline for

  • Nikolai J. Hopf - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart
  • Javier Segovia von Riehm - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart
  • Holger Opitz - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.04.01

doi: 10.3205/13dgnc029, urn:nbn:de:0183-13dgnc0294

Published: May 21, 2013

© 2013 Hopf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Craniopharyngiomas are still surgically challenging because of their location in the complex sella area, adherence to vulnerable neurovascular structures, and high recurrence rate. Presently, surgical resection using a transcranial route is the recommended first line treatment. With the introduction of endoscopic transsphenoidal techniques in the last few years, it has been advocated that Craniopharyngeomas may be easier and safer removed using the transsphenoidal route. Objective of this study is to compare our results using a transcranial versus a transsphenoidal route for resection of Craniopharyngeomas.

Method: We retrospectively analyzed 23 operations performed in 17 patients suffering from Craniopharyngiomas. 12 tumors were operated using a transcranial minimally invasive approach (7 subfrontal, 5 transventricular), 11 endoscopic transsphenoidal approach. Patient's age ranged from 7 to 71 years. Four patients had recurrent tumors in the transcranial group and 2 in the transsphenoidal group. Outcome, resection grade, and complications were evaluated.

Results: Gross total resection could be achieved in 5 out of 12 cases in the transcranial group and in 10 out of 11 in the transsphenoidal group. Approach related complications were infection requiring surgical revision in 1 patient in the transcranial group and CSF leaks in 3 cases in the transsphenoidal route, requiring surgical revision in 2 cases. Diabetes insipidus, hypothalamic dysfunction, and visual deficits were less frequent in the transsphenoidal group.

Conclusions: Our retrospective data show, that endoscopic transsphenoidal resection provides a higher rate of gross total resection (10/11 tumors) and a better outcome for Craniopharyngeomas compared with the transcranial route, even when using minimally invasive technique. However, CSF leaks are more prominent (3/11) using the transsphenoidal route.