ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT U SỌ HẦU QUA ĐƯỜNG MỔ THÓP BÊN TRƯỚC

Abstract

Objective: Evaluate the results of craniopharyngioma resection by the pterion approach. Subjects and methods: Retrospective study describing a series of patients diagnosed with craniopharyngioma, treated at the Neurosurgery Department of Cho Ray Hospital from January 2019 to June 2023, and underwent surgery by pterion craniotomy and we collected 35 cases of patients fulfilling the mentioned conditions. Results: In 35 cases of craniopharyngioma operated by the pterion craniotomy, there were 25.8% of cases had gross total resection, 51.4% of cases were able to remove ≥ 90% of the tumor or had near total resection. The common properties of craniopharyngioma were a mixed form of cystic and solid tissue and accompanied by calcification (80%). Most cases after operation were awake with GCS 14-15 points (74.3%). The complication after surgery were 6.4% of cases had epilepsy and 2.9% of cases had limb weakness. 68.6% of cases had diabetes insipidus on the first day after operation. Among them, diabetes insipidus was registered to occurr on permanent, transient and three-phase condition at the rate of 35.3%, 29.4% and 11.8%, respectively. According to pathology, it was recorded that 62.8% of cases were adamantinomatous craniopharyngiomas, 34.3% of cases were papillary craniopharyngiomas and 2.9% of cases could not be classified. In 35 cases that were operated and treated, 54.3% of cases were discharged with GOS 5, following by 37.1% of GOS 4 cases, and 5.7% of GOS 2. The mortality rate after treatment is 8.6%. The recurrence rate during follow-up and treatment was 18%. Conclusion: Craniopharyngioma surgery by pterion approach is not only effective in the surgical treatment of craniopharyngioma, but also contributes to aesthetics and is less invasive in craniopharyngeal surgery.