Outcomes of the endoscopic endonasal approach for tumors in the third ventricle or invading the third ventricle. (August 2021)

• Record Type: Journal Article
• Authors: Seo, Youngbeom; Kim, Yong Hwy; Kim, Jung Hee; Kong, Doo-Sik; Dho, Yun-Sik; Kang, Ho; Kim, Kyung-Min; Kim, Jin Wook; Park, Chul-Kee
• Is Part Of: Journal of clinical neuroscience. Volume 90(2021)
• Page Start: 302
• Page End: 310
• Publication Date: 2021-08
• Subjects: Intraventricular -- Third ventricle -- Endoscopic -- Pituitary surgery -- Craniopharyngioma -- Outcome; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2021.06.012
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: The third ventricle is considered one of the most challenging locations to approach surgically. The pure endoscopic transsphenoidal (EEA) technique has expanded the horizons of this route recently. We investigated the safety and clinical efficacy of EEA in patients with the third ventricle tumors. Abstract: We aimed to retrospectively analyze the surgical and clinical outcomes of the endoscopic endonasal approach (EEA) for tumors in the third ventricle or invading the third ventricle. In total, 82 patients who had undergone surgical treatment using the EEA for tumors involving the third ventricle were enrolled in this study. This cohort study comprised 46 male and 36 female patients. The median age was 37 years (range, 5–76), and the median follow-up duration was 56.5 months (range, 6–117). Seventy-six patients had craniopharyngiomas, and 6 had gangliocytomas, gangliogliomas, astrocytomas, diffuse midline gliomas and lymphomas. Gross total removal was performed in 71 (86.5%) of the 82 patients, subtotal tumor removal in 7 patients and partial removal or biopsy in 4 patients. The pituitary stalk was preserved in 20 cases. Visual function improved in 40 (81.6%) of 49 patients. Endocrine function worsened in 41 (50%) of 82 patients. Hypothalamic function improved in 16 (72.7%) of 22 cases. Postoperative obesity occurred in 3 (20.0%) of 15 children and 11 (23.9%) of 46 adult patients. The postoperative cerebrospinal fluid leakage rate was 3.6%. Postoperative meningitis occurred in 18 (21.9%) cases. Permanent diabetes insipidus was identified in 73 (89.0%) of 82 patients. Tumor recurrence was observed in 10 patients (12%). The EEA appears to be a safe and effective treatment modality for tumors in the third ventricle or involving the third ventricle. However, more cases and long-term follow-up outcomes are required to confirm the clinical efficacy of the EEA.