INTRACAVITARY TREATMENT OF INTRASELLAR CYSTIC CRANIOPHARYNGEOMAS WITH90-YTTRIUM BY TRANS-SPHENOIDAL APPROACH - A TECHNICAL NOTE

Intracavitary irradiation of intrasellar cystic craniopharyngeomas by stereotactic cyst puncture and injection of radioactive solutions is n ot yet possible. Therefore we designed a new method which allows such intracavitary irradiation. Its principle is a transsphenoidal approach with only a small bony opening of the sella floor, followed by cyst p uncture, exclusion of cyst leakage by Metrizamid injection under x-ray control, injection of Y-90-colloid solution at a dosage wich delivers a radiation of 200 Gy to the cyst wall, and finally tight closure of the puncture site using fibrin glue and gelfoam. This method has been used in three patients with good results (follow-up 12-15 months) and without complications. Even though long-term follow-up is not yet avai lable, our preliminary results suggest that this method will be useful for future patients with intrasellar cystic craniopharyngeomas.