Xiaoqing Li1, Wei Wu1, Qing Miao1, Min He1, Shuo Zhang1, Zhaoyun Zhang1, Bin Lu1, Yehong Yang1, Xuefei Shou2, Yiming Li1, Yongfei Wang3, Hongying Ye4. 1. Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China. 2. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China. 3. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: eamns@hotmail.com. 4. Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: yehongying@huashan.org.cn.
Abstract
OBJECTIVE: Craniopharyngiomas have traditionally been resected through the transcranial approaches (TCA). The endoscopic endonasal approach (EEA) has recently been developed as an alternative for surgeons, but controversy remains regarding which approach has better outcomes. We compared the endocrine and metabolic outcomes of TCA and EEA in patients who underwent primary resection of craniopharyngiomas. METHODS: A retrospective analysis was conducted of patients with craniopharyngioma who were treated by the department of endocrinology and metabolism at our institution between 2011 and 2015. RESULTS: Of 43 patients assessed, 26 underwent TCA and 17 underwent EEA. After surgery, 29.4% (5/17) of patients in the EEA group had normal anterior pituitary function, whereas none in the TCA group had complete anterior pituitary function. Higher prevalences of corticotropic deficiency (92.3% vs. 52.9%, P = 0.009), thyrotrophic deficiency (96.2% vs. 52.9%, P = 0.003), and hypogonadotropic hypogonadism (100% vs. 70.6%, P = 0.014) were found in the TCA group. The TCA group showed a trend toward having more patients with at least 3 anterior pituitary deficits (88.5% vs. 58.8%, P = 0.060). The mean body mass index at last follow-up tended to be lower in the EEA group (24.13 ± 3.16 kg/m2 vs. 26.79 ± 4.5 kg/m2, P = 0.079), and the preoperative body mass index was comparable between groups. Similar prevalences of overweight/obesity, hypertension, hyperglycemia, and metabolic syndrome were detected in the 2 groups. Moreover, no significant differences were observed in the rates of cerebrospinal fluid leakage and intracranial infection between the 2 groups. CONCLUSIONS: EEA may provide the same gross total resection rate for craniopharyngioma as TCA while providing better protection of anterior pituitary function.
OBJECTIVE:Craniopharyngiomas have traditionally been resected through the transcranial approaches (TCA). The endoscopic endonasal approach (EEA) has recently been developed as an alternative for surgeons, but controversy remains regarding which approach has better outcomes. We compared the endocrine and metabolic outcomes of TCA and EEA in patients who underwent primary resection of craniopharyngiomas. METHODS: A retrospective analysis was conducted of patients with craniopharyngioma who were treated by the department of endocrinology and metabolism at our institution between 2011 and 2015. RESULTS: Of 43 patients assessed, 26 underwent TCA and 17 underwent EEA. After surgery, 29.4% (5/17) of patients in the EEA group had normal anterior pituitary function, whereas none in the TCA group had complete anterior pituitary function. Higher prevalences of corticotropic deficiency (92.3% vs. 52.9%, P = 0.009), thyrotrophic deficiency (96.2% vs. 52.9%, P = 0.003), and hypogonadotropic hypogonadism (100% vs. 70.6%, P = 0.014) were found in the TCA group. The TCA group showed a trend toward having more patients with at least 3 anterior pituitary deficits (88.5% vs. 58.8%, P = 0.060). The mean body mass index at last follow-up tended to be lower in the EEA group (24.13 ± 3.16 kg/m2 vs. 26.79 ± 4.5 kg/m2, P = 0.079), and the preoperative body mass index was comparable between groups. Similar prevalences of overweight/obesity, hypertension, hyperglycemia, and metabolic syndrome were detected in the 2 groups. Moreover, no significant differences were observed in the rates of cerebrospinal fluid leakage and intracranial infection between the 2 groups. CONCLUSIONS:EEA may provide the same gross total resection rate for craniopharyngioma as TCA while providing better protection of anterior pituitary function.
Authors: Bryan Lubomirsky; Zachary B Jenner; Morgan B Jude; Kiarash Shahlaie; Reza Assadsangabi; Vladimir Ivanovic Journal: Neuroradiol J Date: 2021-12-02