4.3 Article

Outcomes of the endoscopic endonasal approach for tumors in the third ventricle or invading the third ventricle

Journal

JOURNAL OF CLINICAL NEUROSCIENCE
Volume 90, Issue -, Pages 302-310

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2021.06.012

Keywords

Intraventricular; Third ventricle; Endoscopic; Pituitary surgery; Craniopharyngioma; Outcome

Funding

  1. Seoul National University Hospital [0520200030]

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This retrospective study analyzed the surgical and clinical outcomes of 82 patients with tumors in or invading the third ventricle who underwent treatment using the endoscopic endonasal approach (EEA). The study found that EEA is a safe and effective treatment modality for tumors in the third ventricle, but further research with more cases and long-term follow-up is needed to confirm its clinical efficacy.
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. (c) 2021 Elsevier Ltd. All rights reserved.

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