Endoscopic-assisted microscopic excision for large recurrent craniopharyngioma

Objectives: To evaluate the feasibility and outcomes of endoscopically-assisted microsurgery in large recurrent craniopharyngiomas. Materials and Methods: We reported 25 Patients who underwent endoscopically assisted micro neurosurgery for large craniopharyngioma and assessed the outcome of excision and its correlation to morbidity and mortality from January 2020 to September 2023 in Cairo University Hospitals. Results: In our study, we recorded the age range from 7 to 54 years old, with a mean age of 22.92. 18 patients (72%) were female, and 7 patients (28%) were male. We recorded the average size of the tumor as 63.6 cm 3 . Total resection was achieved in 18 patients (72%) and subtotal resection in 7 patients (28%). Pituitary stalk was preserved in 13 patients (52%). The pathology we have found 12 cases (48%) were papillary type, and 13 cases (52%) were adamantinoma, Tous type. Diabetes insipidus developed in 15 patients (60%) who presented in the immediate period and persisted only in 4 patients at 1-year follow-up. Conclusion: Endoscopic assistance is valuable as it can identify tumor remnants (less than <1cm) in critical areas that would be missed by the microscope alone.