Endoscopic Endonasal Apprach Surgery for Craniopharyngiomas

UPMC On Topic Video Transcript

Paul A. Gardner, MD

Director, Center for Skull Base Surgery

A craniopharyngioma is a rare, benign tumor that occurs in the pituitary, both in the gland itself as well as in the stalk, which is the stem that connects the brain to the pituitary. They occur in both children and adults, in fact, occur equally commonly in children and adults. These tumors can present with vision loss, or they can even harm hormone function.

The primary treatment for craniopharyngioma is removal of the tumor through surgery but this can be very difficult sometimes to cure, as the tumor can grow into areas of the brain that are so delicate that surgery could be damaging.

Advantage: Endoscopic Endonasal Approach

So an endoscopic endonasal approach has become really a favorite approach for treating craniopharyngioma. It provides us a corridor into the tumor without touching the brain or, as or more importantly, without touching the eye nerves: the optic nerves. Often vision is significantly affected by these tumors and we can sneak in under those nerves and also under the brain by coming through the nose and landing directly on the tumor.

One of the more difficult areas of the tumor sometimes is also where it expands up into the brain. The endoscope allows us to see very closely that interface with the brain, and I think allows us to preserve both that function as well as the function of the eye nerves.

Multidisciplinary, Experienced Team

The advantage of coming to UPMC Presbyterian for treatment of craniopharyngioma is largely our experience as well as our multidisciplinary team. We have significant experience with the endoscopic endonasal approach of over a decade. We recently published our series of treatment of craniopharyngioma of over 75 patients with excellent results which are, overall, better than with open surgery. We had better visual results and we also were able to often preserve pituitary function when possible.

We have a multidisciplinary team as well which consists of endocrinologists, neurosurgeons, ear, nose and throat doctors and pediatric neurosurgeons, which allow us to take care of and operate on the full wide range of patients who can have craniopharyngioma.

For more information, contact us at (412) 647-3685, or visit the Cranial Base Center at the University of Pittsburgh.