Combined microsurgical extra-axial and transcortical transventricular endoscopic excision of parasellar tumors with ventricular extension

Sella/parasellar tumors with intraventricular extension present unique neurosurgical challenges in achieving gross total resection with minimal morbidity and mortality. Firm attachment of large tumors, especially craniopharyngiomas, in this location to critical structures, makes the goal of complete microsurgical resection more difficult to attain. Several traditional surgical approaches are available. We report two patients who had novel combination of the traditional extra-axial microsurgical and transcortical transventricular endoscopic approaches to resect sellar/suprasellar tumors with intraventricular extension as either staged or simultaneous procedures.