Endoscopic Transventricular Approach to Craniopharyngiomas

The endoscopic intraventricular approach for the treatment of craniopharyngiomas is an appealing option which might achieve an even wider utilization since the more effective, newer adjuvant treatments prioritize the reduction of the morbidity of any surgical operation over the desire for an aggressive surgical resection. Neuroendoscopy can establish the diagnosis by tissue sampling, it can offer symptomatic relief by cyst decompression, and it can reduce the size of the tumor, thus optimizing the target for fractionated radiation therapy (RT) or enabling stereotactic radiosurgery. Moreover, it can act as a temporizing measure for very young pediatric patients in whom RT should be avoided, or for older patients who prefer this approach. Herein, we analyze the indications and we provide a synopsis of the operative technique.