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Traditional microsurgical approaches for addressing intraventricular craniopharyngioma provide limited access to the retrochiasmatic area and tumors with significant lateral or rostrocaudal extensions. Extended endoscopic endonasal approaches can effectively overcome many of limitations, yet they require a favorable working angle between the optic chiasm and pituitary gland, as well as the involvement of the third ventricle floor by the tumor. Herein, the authors describe the surgical nuances of a keyhole technique for resecting third ventricle craniopharyngiomas via a fully endoscopic minimally invasive trans-eyebrow supraorbital translaminar approach (ESOTLA). A case description detailing the key surgical steps and application of the approach is provided, along with a series of cadaveric photographs to highlight the relevant anatomy and step-by-step dissection process. The patient is a 44-year-old man who presented with polyuria, low urine specific gravity, and panhypopituitarism. Brain magnetic resonance imaging revealed a solid-cystic heterogeneous-enhanced retrochiasmatic mass within the third ventricle, consistent with craniopharyngioma. A 1-stage ESOTLA was indicated based on the narrow pituitary-chiasm angle and the high functional status of the patient. Near-total resection was achieved, and no new postoperative neurologic or endocrine change was observed. Targeted therapy was implemented based on the histologic result, and the most recent surveillance magnetic resonance imaging showed no evidence of the residual tumor. By combining a keyhole approach with variable-angle endoscopic visualization through a smaller bony and soft tissue exposure, ESOTLA can provide enhanced illumination within the third ventricle, potentially addressing cosmetic concerns and limited exposure area/angle of freedom associated with its conventional microsurgical counterpart. [ABSTRACT FROM AUTHOR]

This article discusses the extended transplanum/transtuberculum endoscopic endonasal approach (EEA) for the surgical treatment of suprasellar tumors, specifically craniopharyngiomas. The study outlines the surgical techniques and steps involved in customizing the bone drilling and dural opening based on the tumor's relationship to the pituitary stalk. The article provides cadaveric dissection photos and intraoperative findings from three cases to illustrate the surgical nuances and minimal exposures required for different types of suprasellar craniopharyngiomas. The authors emphasize the importance of a customized approach to ensure a safe surgical corridor while minimizing unnecessary overexposure. [Extracted from the article]

This article provides a systematic literature review of intracranial ectopic Rathke's cleft cysts (RCCs), which are benign congenital lesions located in the sellar and suprasellar regions. The authors present a case of a symptomatic ectopic retrosellar RCC that caused extensive clival erosion. The study includes data on patient demographics, clinical presentation, and treatment details. Surgical approaches varied depending on the cyst's location, and gross total resection was achieved in the majority of cases. The article concludes that further research is needed to better understand the natural history and long-term outcomes of these cysts. [Extracted from the article]

The article titled "Fully Endoscopic Supraorbital Translaminar Approach: Step-by-Step Illustrative Description" discusses a surgical technique called the fully endoscopic supraorbital translaminar approach (ESOTLA) for the management of third ventricle tumors. The traditional microsurgical approaches have limitations in accessing certain tumors and pose risks to nearby neurovascular structures, prompting the exploration of alternative techniques. ESOTLA combines a minimally invasive keyhole approach with endoscopic visualization, providing enhanced illumination and a broader field of view within the third ventricle. This technique offers improved cosmetic and neurological outcomes compared to other approaches, although it has limitations for certain types of tumors. The article includes a detailed case description and photographs to guide the surgical process. [Extracted from the article]

This article discusses the successful treatment of recurrent lymphocytic hypophysitis (LH) using fractionated stereotactic radiotherapy (FSRT). LH is a rare autoimmune inflammation of the pituitary gland that can mimic pituitary adenomas. The authors conducted a systematic literature review and found that FSRT can be a viable alternative treatment for refractory cases of LH. The study included eight patients, and seven of them achieved a complete clinical response after one course of radiation. FSRT offers long-term disease control while minimizing radiation exposure to nearby critical structures. However, further studies are needed to determine the long-term effects, optimal dose planning, and patient selection criteria for FSRT. [Extracted from the article]