{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:04:02Z","timestamp":1786125842495,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2021,5]]},"abstract":"Abstract<\/jats:title>\n \n Microsurgical resection of craniopharyngiomas poses significant challenges, which are amplified with tumors in the retrochiasmatic location and larger size. Traditional pterional trans-sylvian, subfrontal translamia terminalis, or interhemispheric approaches provide narrow surgical corridors with obstructed visualization of the tumor by the prefixed chiasm and slit optic carotid window.\n 1\u20135<\/jats:sup>\n The superior extension of the tumor compressing the hypothalamus and third ventricle are likewise inaccessible. Dissection through these approaches requires crossing and manipulation of the already compromised optic apparatus with surgical instruments. Finally, the basilar artery and its perforating branches are often adherent to the posterior aspect of the tumor, and are invisible.\n <\/jats:p>\n \n Endonasal endoscopic techniques have been utilized as a surgical approach that accesses the tumor without crossing the optic apparatus; however, these approaches have a significant risk of cerebrospinal fluid leakage and require dissection of the basilar artery and hypothalamus from long distances with lengthy instruments.\n 6\u20139<\/jats:sup>\n Frequently, the surgeon achieves only partial removal.\n <\/jats:p>\n \n The petrosal approach is ideal for tumors in the retrochiasmatic location.\n 10\u201313<\/jats:sup>\n Advantages include unhindered access to the retrochiasmatic space without crossing the optic nerve and chiasm. The angle of approach allows visualization superiorly to the hypothalamus. Additionally, the approach shortens the distance to the tumor, allowing for delicate bimanual dissection of the tumor, especially at the basilar artery and hypothalamic interfaces.\n <\/jats:p>\n This video demonstrates three cases of retrochiasmatic craniopharyngioma resection through the petrosal approach, highlighting these advantages to optimize patient outcome. The patients and guardians consented for the surgery, photography, and publication of the patient's image.<\/jats:p>\n \n Figures from Al-Mefty et al\n 11<\/jats:sup>\n used with permission from the Journal of Neurosurgery Publishing Group.\n <\/jats:p>\n \n Additional figures republished from Al-Mefty et al.\n 12<\/jats:sup>\n \u201cThe petrosal approach for the resection of retrochiasmatic craniopharyngiomas,\u201d\n Neurosurgery<\/jats:italic>\n , 2008, volume 62, issue 5 Suppl 2 (ONS), ONS331-ONS336, by permission of the Congress of Neurological Surgeons.\n <\/jats:p>","DOI":"10.1093\/ons\/opab045","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T12:03:58Z","timestamp":1620043438000},"page":"E420-E421","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Petrosal Approach for Giant Retrochiasmatic Craniopharyngioma: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"20","author":[{"given":"Kadir","family":"Erkmen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Aboud","sequence":"additional","affiliation":[{"name":"Arkansas Neuroscience Institute, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ossama","family":"Al-Mefty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,6]]},"reference":[{"issue":"4","key":"bib1-20251027","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1227\/00006123-198510000-00009","article-title":"Microsurgery for giant craniopharyngiomas in children","volume":"17","author":"Al-Mefty","year":"1985","journal-title":"Neurosurgery"},{"issue":"2","key":"bib2-20251027","doi-asserted-by":"crossref","first-page":"237","DOI":"10.3171\/jns.1999.90.2.0237","article-title":"Surgical treatment of craniopharyngiomas: experience with 168 patients","volume":"90","author":"Fahlbusch","year":"1999","journal-title":"J Neurosurg"},{"issue":"4","key":"bib3-20251027","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3171\/2009.5.PEDS09106","article-title":"Modified orbitozygomatic craniotomy for craniopharyngioma resection in children","volume":"4","author":"Golshani","year":"2009","journal-title":"J Neurosurg Pediatr"},{"issue":"4","key":"bib4-20251027","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1097\/00006123-200010000-00014","article-title":"Craniopharyngiomas of the third ventricle: trans-lamina terminalis approach","volume":"47","author":"Maira","year":"2000","journal-title":"Neurosurgery"},{"issue":"1","key":"bib5-20251027","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3171\/jns.1990.73.1.0003","article-title":"Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients","volume":"73","author":"Yasargil","year":"1990","journal-title":"J Neurosurg"},{"issue":"6 Suppl 3","key":"bib6-20251027","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1227\/01.NEU.0000333786.98596.33","article-title":"Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: anatomic considerations\u2014part 1","volume":"62","author":"Cavallo","year":"2008","journal-title":"Neurosurgery"},{"issue":"4","key":"bib7-20251027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/2011.1.FOCUS10297","article-title":"Surgical nuances for removal of retrochiasmatic craniopharyngioma via the endoscopic endonasal extended transsphenoidal transplanum transtuberculum approach","volume":"30","author":"Liu","year":"2011","journal-title":"Neurosurg Focus"},{"issue":"4","key":"bib8-20251027","doi-asserted-by":"crossref","first-page":"715","DOI":"10.3171\/JNS\/2008\/108\/4\/0715","article-title":"Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum","volume":"108","author":"Kassam","year":"2008","journal-title":"J Neurosurg"},{"issue":"1","key":"bib9-20251027","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2019.10.FOCUS19728","article-title":"Endoscopic endonasal surgery outcomes for pediatric craniopharyngioma: a systematic review","volume":"48","author":"Soldozy","year":"2020","journal-title":"Neurosurg Focus"},{"key":"bib10-20251027","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/978-3-7091-9183-5_27","article-title":"The petrosal approach: indications, technique, and results","volume":"53","author":"Al-Mefty","year":"1991","journal-title":"Acta Neurochir Suppl (Wien)"},{"issue":"2 Suppl","key":"bib11-20251027","first-page":"87","article-title":"The petrosal approach for the total removal of giant retrochiasmatic craniopharyngiomas in children","volume":"106","author":"Al-Mefty","year":"2007","journal-title":"J Neurosurg"},{"issue":"5 Suppl 2","key":"bib12-20251027","first-page":"ONS331","article-title":"The petrosal approach for the resection of retrochiasmatic craniopharyngiomas","volume":"62","author":"Al-Mefty","year":"2008","journal-title":"Neurosurgery"},{"issue":"4","key":"bib13-20251027","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/0090-3019(85)90300-3","article-title":"Transpetrosal-transtentorial approach and its application in the therapy of retrochiasmatic craniopharyngiomas","volume":"24","author":"Hakuba","year":"1985","journal-title":"Surg Neurol"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/20\/6\/E420\/37908054\/opab045.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab045","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:02:54Z","timestamp":1786122174000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opab045","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]},"assertion":[{"value":"2020-12-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}