Endoscopic occipital transtentorial transpineal-recess approach for craniopharyngioma within the third ventricle
10.12025/j.issn.1008-6358.2026.20260210
- VernacularTitle:内镜经枕天幕经松果体隐窝入路治疗第三脑室颅咽管瘤
- Author:
Chongjing SUN
1
;
Tao XIE
2
;
Wensheng LI
3
;
Pin CHEN
1
;
Shuang LIU
1
;
Wei SUN
1
;
Qiang XIE
1
;
Huaichao ZHANG
1
;
Zijiang YANG
1
;
Xiaobiao ZHANG
4
Author Information
1. Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
2. Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Digital Medical Research Center, Fudan University, Shanghai 200032, China;Cancer Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
3. Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Shanghai 200032, China;Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
4. Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Digital Medical Research Center, Fudan University, Shanghai 200032, China;Cancer Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Shanghai 200032, China;Department of Neurosurgery, Shanghai Geriatric Medical Center, Shanghai 201104, China.
- Publication Type:Promptreport
- Keywords:
neuroendoscopy;
third ventricle;
endoscopic occipital transtentorial transpineal-recess approach;
craniopharyngioma
- From:
Chinese Journal of Clinical Medicine
2026;33(5):838-843
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of the endoscopic occipital transtentorial transpineal-recess (EOTT-TR) approach for treatment of craniopharyngiomas within the third ventricle. Methods The clinical and imaging data of a 54-year-old female patient with craniopharyngioma was reviewed. The patient was presented with progressive visual impairment and headache for six months. Endocrine evaluation indicated mild impairment of the pituitary-hypothalamic axis function. Imaging revealed a large solid tumor was entirely confined within the third ventricle, maximal diameter of approximately 4.7 cm. The lesion was resected via right EOTT-TR approach, which involved upward retraction of the pineal gland under the 3D endoscopy, and accessing the third ventricle through the pineal recess. Following resection, pathological diagnosis was performed, and postoperative complications were observed. Results Subtotal resection was achieved. Postoperatively, central diabetes insipidus, diplopia and upward gaze dysfunction occurred, but improved after 3 months of follow-up. MRI confirmed subtotal resection of the tumor, and the vision of the patient was improved, and the Karnofsky performance status (KPS) score increased from 80 points to 90 points at 3 months after operation. The pathological diagnosis was papillary craniopharyngioma (WHO grade Ⅰ). Conclusions The EOTT-TR approach provides a unique postero-superior to antero-inferior perspective, allowing full exposure of the third ventricle. It is particularly advantageous for treating craniopharyngiomas originating from the antero-inferior wall of the third ventricle, enabling tumor resection while preserving hypothalamic function without affecting visual acuity or visual fields. Therefore, for craniopharyngiomas strictly confined within the third ventricle, the EOTT-TR approach is a feasible surgical approach.
