Extended Pterional Approach for Initial Surgical Management of Craniopharyngiomas: A Case Series

AIM: Treatment of craniopharyngiomas remains challenging. The aim of this study was to evaluate results of initial surgical management of craniopharyngiomas via the extended pterional approach. MATERIAL and METHODS: Nineteen patients (10 female; median age of 23 years; ranging from 10 months to 67 years) undergone initial surgery for craniopharyngiomas through the extended pterional approach. Data were retrospectively collected by reviewing medical records, operative reports and imaging results. RESULTS: The median size of craniopharyngiomas was 3.2 cm (range 1.3 -4.8).Visual deterioration (n=12) and headache (n=10) were the most common symptoms on admission. After surgery, one patient died due to medical complications, 12 patients developed diabetes insipidus and eight patients developed anterior pituitary dysfunction. Median follow-up period was 9 years (range 2 13). Patients with progression of craniopharyngioma (n=5) when compared to patients without progression of craniopharyngioma (n=14) were significantly younger at the time of surgery, had less visual deterioration before surgery and had higher rates of not changed vision after surgery. Children had larger craniopharyngiomas when compared to adults. CONCLUSION: Initial surgery for craniopharyngioma via the extended pterional approach is a safe and effective treatment option with low postoperative mortality, and acceptable postoperative morbidity and recurrence rate.