AN APPROACH TO RADICAL EXCISION OF CRANIOPHARYNGIOMA BY THE TEMPORAL ROUTE

Attempts at radical excision of craniopharyngioma has been made increa singly possible by the advent of neuroradiological imaging and the use of microscopic technique. Between 1977 and 1993, 62 patients of The N ational Hospital for Neurology and Neurosurgery, London, have undergon e surgical excision of craniopharyngioma by the temporal route, with a small anterior temporal resection. Surgical mortality was 4%. Forty-e ight patients (76%) remain well on average follow-up of 34 months. Twe lve percent had major complications (hypothalamic damage, subdural hae matoma, scalp collections requiring shunt drainage). There were four r ecurrences in patients where the initial operations were considered as complete microscopic excision. Maximal control of tumour recurrence b y removal of all tumour accessible and visible to the surgical microsc ope is best achieved by radical excision at the first operation.