Removal of Craniopharyngioma by a Unilateral Interhemispheric Trans-Lamina Terminalis Approach: Operative Procedures and Postoperative Management

The majority of craniopharyngiomas is located in the suprasellar region and extends toward the third ventricle behind the chiasm. The retrochiasmal portion of the tumor cannot be removed under direct observations by an ordinary pterional or subfrontal approach alone. We have experienced 42 craniopharyngiomas in adults during the 15 years from 1970 to 1984. Biopsy or partial removal of the tumor followed by irradiation has been our standard treatment. Among 37 cases treated by this regimen, 14 deaths (38%) have occurred during the follow-up period of one year to 15 years. Recently, we have used a unilateral interhemispheric trans-lamina terminalis approach to attempt radical excision of craniopharyngiomas. The operative procedures and postoperative management of the patients are described.