{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:05:33Z","timestamp":1780131933510,"version":"3.54.0"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2014,10]]},"abstract":"\n Object<\/jats:title>\n In the last decade the indications for the endoscopic endonasal approach have been progressively expanded to include lesions that have not been traditionally considered amenable to resection through the transsphenoidal route. In this study, the authors analyze their experience with hypothalamic gliomas treated via the endoscopic endonasal approach.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Consecutive cases of hypothalamic gliomas treated since 2007 via an endoscopic endonasal approach were reviewed. Preoperative and postoperative neuroimaging as well as endocrinological, neurological, and visual symptoms were analyzed to assess the surgical outcome. Signs and symptoms of hypothalamic dysfunction including body mass index (BMI), memory, sleep-wake rhythm, and polyphagia were prospectively collected pre- and postoperatively to assess hypothalamic function. Quality of life was evaluated using the Katz scale.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In the initial phase the endoscopic endonasal approach was adopted in 3 cases with a palliative intent, to obtain a biopsy sample or for debulking of the mass followed by radio- or chemotherapy. In 2 later cases it was successfully adopted to achieve gross-total tumor resection. Complications consisted of 2 postoperative CSF leaks, which required an endoscopic endonasal reintervention. Visual deficit improved in 3 cases and normalized in the other 2. Four patients developed diabetes insipidus, and 3 an anterior panhypopituitarism. All patients had a moderate increase in BMI. No patients presented with any other signs of hypothalamic damage, and their quality of life at follow-up is normal.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Despite the limitations of a short follow-up and small sample, the authors\u2019 early experience with the endoscopic endonasal approach has revealed it to be a direct, straightforward, and safe approach to third ventricle astrocytomas. It allowed the authors to perform tumor resection with the same microsurgical technique: dissecting the tumor with 2 hands, performing a central debulking, and controlling the bleeding with bipolar coagulation. The main limitations were represented by some anatomical conditions, such as the position of the chiasm and the anterior communicating artery complex and, finally, by the challenge of watertight plastic repair. To definitively evaluate the role of this approach in hypothalamic gliomas, a comparison with transcranial series would be necessary, but due to the rarity of these cases such a study is still lacking. The authors observed that more aggressive surgery is associated with a worse endocrinological outcome; thus they consider it to be an open question (in particular in prepubertal patients) whether radical removal is an advisable goal for hypothalamic gliomas.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.7.focus14317","type":"journal-article","created":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T04:43:47Z","timestamp":1412138627000},"page":"E11","source":"Crossref","is-referenced-by-count":23,"title":["Expanding indications for the extended endoscopic endonasal approach to hypothalamic gliomas: preliminary report"],"prefix":"10.3171","volume":"37","author":[{"given":"Matteo","family":"Zoli","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Center of Surgery for Pituitary Tumors and Endoscopic Skull Base Surgery, IRCCS Istituto delle Scienze Neurologiche, Bellaria Hospital, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mazzatenta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center of Surgery for Pituitary Tumors and Endoscopic Skull Base Surgery, IRCCS Istituto delle Scienze Neurologiche, Bellaria Hospital, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide","family":"Valluzzi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center of Surgery for Pituitary Tumors and Endoscopic Skull Base Surgery, IRCCS Istituto delle Scienze Neurologiche, Bellaria Hospital, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Marucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Ph.D.","sequence":"additional","affiliation":[{"name":"Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Section of Pathology, Bellaria Hospital, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Acciarri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center of Surgery for Pituitary Tumors and Endoscopic Skull Base Surgery, IRCCS Istituto delle Scienze Neurologiche, Bellaria Hospital, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Pasquini","sequence":"additional","affiliation":[{"name":"ENT Department, Azienda Unit\u00e0 Sanitaria Locale di Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center of Surgery for Pituitary Tumors and Endoscopic Skull Base Surgery, IRCCS Istituto delle Scienze Neurologiche, Bellaria Hospital, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0370011","series-title":"Childs Nerv Syst","first-page":"1161","article-title":"Extended endoscopic endonasal approach to the suprasellar parachiasmatic cisterns: anatomic study","volume":"26","author":"Abuzayed","year":"2010"},{"key":"b2-0370011","series-title":"Am J Rhinol Allergy","first-page":"426","article-title":"Expanded endonasal approach using vascularized septal flap reconstruction for skull base tumors has a negative impact on sinonasal symptoms and quality of life","volume":"27","author":"Alobid","year":"2013"},{"key":"b3-0370011","series-title":"Neurosurgery","first-page":"547","article-title":"Transcallosal, interfornicial approaches for lesions affecting the third ventricle: surgical considerations and consequences","volume":"10","author":"Apuzzo","year":"1982"},{"key":"b4-0370011","series-title":"Brain Surgery","first-page":"541","article-title":"Surgery in and around the anterior third ventricle","author":"Apuzzo","year":"1993"},{"key":"b5-0370011","series-title":"Br J Neurosurg","first-page":"374","article-title":"Extended endoscopic transplanum-transtu-berculum approach for pituitary adenomas","volume":"27","author":"Barazi","year":"2013"},{"key":"b6-0370011","series-title":"Adv Tech Stand Neurosurg","first-page":"151","article-title":"Extended endoscopic endonasal approach to the midline skull base: the evolving role of transsphenoidal surgery","volume":"33","author":"Cappabianca","year":"2008"},{"key":"b7-0370011","series-title":"Endoscopic Endonasal Transsphenoidal Surgery","first-page":"137","article-title":"Extended endoscopic approaches to the skull base. Anterior cranial base CSF leaks","author":"Castelnuovo","year":"2003"},{"issue":"3 Suppl","key":"b8-0370011","series-title":"Neurosurgery","first-page":"24","article-title":"Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: anatomic considerations\u2014part 1","volume":"61","author":"Cavallo","year":"2007"},{"key":"b9-0370011","series-title":"Neurosurg Rev","first-page":"27","article-title":"The endoscopic endonasal approach for the management of craniopharyngiomas involving the third ventricle","volume":"36","author":"Cavallo","year":"2013"},{"key":"b10-0370011","series-title":"World Neurosurg","first-page":"348","article-title":"Supraorbital eyebrow craniotomy for removal of intraaxial frontal brain tumors: a technical note","volume":"81","author":"Ditzel Filho","year":"2014"},{"key":"b11-0370011","series-title":"J Neurosurg","first-page":"237","article-title":"Surgical treatment of craniopharyngiomas: experience with 168 patients","volume":"90","author":"Fahlbusch","year":"1999"},{"issue":"5 Suppl 2","key":"b12-0370011","series-title":"Neurosurgery","first-page":"269","article-title":"Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas","volume":"64","author":"Fatemi","year":"2009"},{"key":"b13-0370011","series-title":"J Neurosurg","first-page":"6","article-title":"Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series","volume":"109","author":"Gardner","year":"2008"},{"key":"b14-0370011","series-title":"J Neurosurg","first-page":"1043","article-title":"The evolution of the endonasal approach for craniopharyngiomas. Historical vignette","volume":"108","author":"Gardner","year":"2008"},{"issue":"4 Suppl","key":"b15-0370011","series-title":"Neurosurgery","first-page":"361","article-title":"Transcallosal transchoroidal approach to tumors of the third ventricle","volume":"57","author":"Kasowski","year":"2005"},{"issue":"1","key":"b16-0370011","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica","volume":"19","author":"Kassam","year":"2005"},{"issue":"2 Suppl","key":"b17-0370011","series-title":"J Neurosurg","first-page":"75","article-title":"Fully endoscopic expanded endonasal approach treating skull base lesions in pediatric patients","volume":"106","author":"Kassam","year":"2007"},{"key":"b18-0370011","series-title":"J Neurosurg","first-page":"715","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"},{"key":"b19-0370011","series-title":"J Neurosurg","first-page":"1544","article-title":"Endoscopic endonasal skull base surgery: analysis of complications in the authors\u2019 initial 800 patients. A review","volume":"114","author":"Kassam","year":"2011"},{"issue":"3 Suppl 1","key":"b20-0370011","series-title":"Neurosurgery","first-page":"57","article-title":"Endoscopic endonasal pituitary transposition for a transdorsum sellae approach to the interpeduncular cistern","volume":"62","author":"Kassam","year":"2008"},{"issue":"1 Suppl 1","key":"b21-0370011","series-title":"Neurosurgery","first-page":"ONS44","article-title":"Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap","volume":"63","author":"Kassam","year":"2008"},{"key":"b22-0370011","series-title":"JAMA","first-page":"914","article-title":"Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function","volume":"185","author":"Katz","year":"1963"},{"key":"b23-0370011","series-title":"J Neurosurg","first-page":"825","article-title":"Extended transsphenoidal approach","volume":"102","author":"Laws","year":"2005"},{"issue":"Suppl 1","key":"b24-0370011","series-title":"Pediatr Neurosurg","first-page":"57","article-title":"Transsphenoidal removal of craniopharyngioma","volume":"21","author":"Laws","year":"1994"},{"key":"b25-0370011","series-title":"Childs Nerv Syst","first-page":"691","article-title":"Craniopharyngioma: the pendulum of surgical management","volume":"21","author":"Sainte-Rose","year":"2005"},{"key":"b26-0370011","series-title":"Zentralbl Neurochir","first-page":"17","article-title":"Surgical treatment of craniopharyngiomas","volume":"52","author":"Samii","year":"1991"},{"key":"b27-0370011","series-title":"Schmidek & Sweet Operative Neurosurgical Techniques: Indications, Methods and Results","first-page":"489","article-title":"Surgical management of craniopharyngiomas","volume":"1","author":"Samii","year":"2000"},{"key":"b28-0370011","series-title":"World Neurosurg","article-title":"An eyebrow for an eyebrow and a nose for a nose","author":"Schwartz","year":"2013"},{"issue":"5","key":"b29-0370011","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Expanded endonasal endoscopic resection of anterior fossa meningiomas: report of 13 cases and meta-analysis of the literature","volume":"30","author":"Van Gompel","year":"2011"},{"key":"b30-0370011","series-title":"World Neurosurg","article-title":"The supraorbital endoscopic approach for tumors","author":"Wilson","year":"2013"},{"issue":"6 Suppl 3","key":"b31-0370011","series-title":"Neurosurgery","first-page":"1029","article-title":"Surgery of intraventricular tumors","volume":"62","author":"Ya\u015fargil","year":"2008"},{"key":"b1-0370011","series-title":"Childs Nerv Syst","first-page":"1161","article-title":"Extended endoscopic endonasal approach to the suprasellar parachiasmatic cisterns: anatomic study","volume":"26","author":"Abuzayed","year":"2010"},{"key":"b2-0370011","series-title":"Am J Rhinol Allergy","first-page":"426","article-title":"Expanded endonasal approach using vascularized septal flap reconstruction for skull base tumors has a negative impact on sinonasal symptoms and quality of life","volume":"27","author":"Alobid","year":"2013"},{"key":"b3-0370011","series-title":"Neurosurgery","first-page":"547","article-title":"Transcallosal, interfornicial approaches for lesions affecting the third ventricle: surgical considerations and consequences","volume":"10","author":"Apuzzo","year":"1982"},{"key":"b4-0370011","series-title":"Brain Surgery","first-page":"541","article-title":"Surgery in and around the anterior third ventricle","author":"Apuzzo","year":"1993"},{"key":"b5-0370011","series-title":"Br J Neurosurg","first-page":"374","article-title":"Extended endoscopic transplanum-transtu-berculum approach for pituitary adenomas","volume":"27","author":"Barazi","year":"2013"},{"key":"b6-0370011","series-title":"Adv Tech Stand Neurosurg","first-page":"151","article-title":"Extended endoscopic endonasal approach to the midline skull base: the evolving role of transsphenoidal surgery","volume":"33","author":"Cappabianca","year":"2008"},{"key":"b7-0370011","series-title":"Endoscopic Endonasal Transsphenoidal Surgery","first-page":"137","article-title":"Extended endoscopic approaches to the skull base. Anterior cranial base CSF leaks","author":"Castelnuovo","year":"2003"},{"issue":"3 Suppl","key":"b8-0370011","series-title":"Neurosurgery","first-page":"24","article-title":"Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: anatomic considerations\u2014part 1","volume":"61","author":"Cavallo","year":"2007"},{"key":"b9-0370011","series-title":"Neurosurg Rev","first-page":"27","article-title":"The endoscopic endonasal approach for the management of craniopharyngiomas involving the third ventricle","volume":"36","author":"Cavallo","year":"2013"},{"key":"b10-0370011","series-title":"World Neurosurg","first-page":"348","article-title":"Supraorbital eyebrow craniotomy for removal of intraaxial frontal brain tumors: a technical note","volume":"81","author":"Ditzel Filho","year":"2014"},{"key":"b11-0370011","series-title":"J Neurosurg","first-page":"237","article-title":"Surgical treatment of craniopharyngiomas: experience with 168 patients","volume":"90","author":"Fahlbusch","year":"1999"},{"issue":"5 Suppl 2","key":"b12-0370011","series-title":"Neurosurgery","first-page":"269","article-title":"Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas","volume":"64","author":"Fatemi","year":"2009"},{"key":"b13-0370011","series-title":"J Neurosurg","first-page":"6","article-title":"Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series","volume":"109","author":"Gardner","year":"2008"},{"key":"b14-0370011","series-title":"J Neurosurg","first-page":"1043","article-title":"The evolution of the endonasal approach for craniopharyngiomas. Historical vignette","volume":"108","author":"Gardner","year":"2008"},{"issue":"4 Suppl","key":"b15-0370011","series-title":"Neurosurgery","first-page":"361","article-title":"Transcallosal transchoroidal approach to tumors of the third ventricle","volume":"57","author":"Kasowski","year":"2005"},{"issue":"1","key":"b16-0370011","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica","volume":"19","author":"Kassam","year":"2005"},{"issue":"2 Suppl","key":"b17-0370011","series-title":"J Neurosurg","first-page":"75","article-title":"Fully endoscopic expanded endonasal approach treating skull base lesions in pediatric patients","volume":"106","author":"Kassam","year":"2007"},{"key":"b18-0370011","series-title":"J Neurosurg","first-page":"715","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"},{"key":"b19-0370011","series-title":"J Neurosurg","first-page":"1544","article-title":"Endoscopic endonasal skull base surgery: analysis of complications in the authors\u2019 initial 800 patients. A review","volume":"114","author":"Kassam","year":"2011"},{"issue":"3 Suppl 1","key":"b20-0370011","series-title":"Neurosurgery","first-page":"57","article-title":"Endoscopic endonasal pituitary transposition for a transdorsum sellae approach to the interpeduncular cistern","volume":"62","author":"Kassam","year":"2008"},{"issue":"1 Suppl 1","key":"b21-0370011","series-title":"Neurosurgery","first-page":"ONS44","article-title":"Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap","volume":"63","author":"Kassam","year":"2008"},{"key":"b22-0370011","series-title":"JAMA","first-page":"914","article-title":"Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function","volume":"185","author":"Katz","year":"1963"},{"key":"b23-0370011","series-title":"J Neurosurg","first-page":"825","article-title":"Extended transsphenoidal approach","volume":"102","author":"Laws","year":"2005"},{"issue":"Suppl 1","key":"b24-0370011","series-title":"Pediatr Neurosurg","first-page":"57","article-title":"Transsphenoidal removal of craniopharyngioma","volume":"21","author":"Laws","year":"1994"},{"key":"b25-0370011","series-title":"Childs Nerv Syst","first-page":"691","article-title":"Craniopharyngioma: the pendulum of surgical management","volume":"21","author":"Sainte-Rose","year":"2005"},{"key":"b26-0370011","series-title":"Zentralbl Neurochir","first-page":"17","article-title":"Surgical treatment of craniopharyngiomas","volume":"52","author":"Samii","year":"1991"},{"key":"b27-0370011","series-title":"Schmidek & Sweet Operative Neurosurgical Techniques: Indications, Methods and Results","first-page":"489","article-title":"Surgical management of craniopharyngiomas","volume":"1","author":"Samii","year":"2000"},{"key":"b28-0370011","series-title":"World Neurosurg","article-title":"An eyebrow for an eyebrow and a nose for a nose","author":"Schwartz","year":"2013"},{"issue":"5","key":"b29-0370011","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Expanded endonasal endoscopic resection of anterior fossa meningiomas: report of 13 cases and meta-analysis of the literature","volume":"30","author":"Van Gompel","year":"2011"},{"key":"b30-0370011","series-title":"World Neurosurg","article-title":"The supraorbital endoscopic approach for tumors","author":"Wilson","year":"2013"},{"issue":"6 Suppl 3","key":"b31-0370011","series-title":"Neurosurgery","first-page":"1029","article-title":"Surgery of intraventricular tumors","volume":"62","author":"Ya\u015fargil","year":"2008"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/37\/4\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/37\/4\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/37\/4\/article-pE11.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:41:55Z","timestamp":1780130515000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/37\/4\/article-pE11.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":62,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2014.7.focus14317","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10]]}}}