{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T22:07:06Z","timestamp":1782252426795,"version":"3.54.5"},"reference-count":76,"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 The interpeduncular cistern, including the retrochiasmatic area, is one of the most challenging regions to approach surgically. Various conventional approaches to this region have been described; however, only the endoscopic endonasal approach via the dorsum sellae and the transpetrosal approach provide ideal exposure with a caudal-cranial view. The authors compared these 2 approaches to clarify their limitations and intrinsic advantages for access to the interpeduncular cistern<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Four fresh cadaver heads were studied. An endoscopic endonasal approach via the dorsum sellae with pituitary transposition was performed to expose the interpeduncular cistern. A transpetrosal approach was performed bilaterally, combining a retrolabyrinthine presigmoid and a subtemporal transtentorium approach. Water balloons were used to simulate space-occupying lesions. \u201cWater balloon tumors\u201d (WBTs), inflated to 2 different volumes (0.5 and 1.0 ml), were placed in the interpeduncular cistern to compare visualization using the 2 approaches. The distances between cranial nerve (CN) III and the posterior communicating artery (PCoA) and between CN III and the edge of the tentorium were measured through a transpetrosal approach to determine the width of surgical corridors using 0- to 6-ml WBTs in the interpeduncular cistern (n = 8).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Both approaches provided adequate exposure of the interpeduncular cistern. The endoscopic endonasal approach yielded a good visualization of both CN III and the PCoA when a WBT was in the interpeduncular cistern. Visualization of the contralateral anatomical structures was impaired in the transpetrosal approach. The surgical corridor to the interpeduncular cistern via the transpetrosal approach was narrow when the WBT volume was small, but its width increased as the WBT volume increased. There was a statistically significant increase in the maximum distance between CN III and the PCoA (p = 0.047) and between CN III and the tentorium (p = 0.029) when the WBT volume was 6 ml.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Both approaches are valid surgical options for retrochiasmatic lesions such as craniopharyngiomas. The endoscopic endonasal approach via the dorsum sellae provides a direct and wide exposure of the interpeduncular cistern with negligible neurovascular manipulation. The transpetrosal approach also allows direct access to the interpeduncular cistern without pituitary manipulation; however, the surgical corridor is narrow due to the surrounding neurovascular structures and affords poor contralateral visibility. Conversely, in the presence of large or giant tumors in the interpeduncular cistern, which widen the spaces between neurovascular structures, the transpetrosal approach becomes a superior route, whereas the endoscopic endonasal approach may provide limited freedom of movement in the lateral extension.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.7.focus14329","type":"journal-article","created":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T04:43:47Z","timestamp":1412138627000},"page":"E12","source":"Crossref","is-referenced-by-count":10,"title":["Anatomic comparison of the endonasal and transpetrosal approaches for interpeduncular fossa access"],"prefix":"10.3171","volume":"37","author":[{"given":"Kenichi","family":"Oyama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Ph.D.","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"},{"name":"Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Prevedello","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo F. S.","family":"Ditzel Filho","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Muto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Ph.D.","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramazan","family":"Gun","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head & Neck Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward E.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head & Neck Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo L.","family":"Carrau","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head & Neck Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5 Suppl 2","key":"b1-0370012","series-title":"Neurosurgery","first-page":"ONS331","article-title":"The petrosal approach for the resection of retrochiasmatic craniopharyngiomas","volume":"62","author":"Al-Mefty","year":"2008"},{"issue":"2 Suppl","key":"b2-0370012","series-title":"J Neurosurg","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"},{"key":"b3-0370012","series-title":"Childs Nerv Syst","first-page":"13","article-title":"Surgery of large retrochiasmatic craniopharyngiomas in children","volume":"6","author":"Ammirati","year":"1990"},{"key":"b4-0370012","series-title":"J Neurosurg","first-page":"578","article-title":"Extended endoscopic endonasal transsphenoidal approach for residual or recurrent craniopharyngiomas. Clinical article","volume":"111","author":"Cavallo","year":"2009"},{"key":"b5-0370012","series-title":"J Neurosurg","first-page":"230","article-title":"Extradural temporopolar approach to lesions of the upper basilar artery and infrachiasmatic region","volume":"81","author":"Day","year":"1994"},{"issue":"5 Suppl 2","key":"b6-0370012","series-title":"Neurosurgery","first-page":"219","article-title":"Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas","volume":"61","author":"de Divitiis","year":"2007"},{"key":"b7-0370012","series-title":"Acta Neurochir (Wien)","first-page":"1213","article-title":"Surgical management of giant craniopharyngiomas","volume":"150","author":"Fahlbusch","year":"2008"},{"key":"b8-0370012","series-title":"J Neurosurg","first-page":"237","article-title":"Surgical treatment of craniopharyngiomas: experience with 168 patients","volume":"90","author":"Fahlbusch","year":"1999"},{"key":"b9-0370012","series-title":"J Neurosurg","first-page":"957","article-title":"Anatomical and quantitative description of the transcavernous approach to interpeduncular and prepontine cisterns. Technical note","volume":"104","author":"Figueiredo","year":"2006"},{"issue":"1 Suppl 1","key":"b10-0370012","series-title":"Neurosurgery","first-page":"ONS75","article-title":"The endoscopic extended transsphenoidal approach for craniopharyngiomas","volume":"59","author":"Frank","year":"2006"},{"key":"b11-0370012","series-title":"J Neurosurg","first-page":"340","article-title":"Zygomatic approach for lesions in the interpeduncular cistern","volume":"62","author":"Fujitsu","year":"1985"},{"key":"b12-0370012","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":"b13-0370012","series-title":"J Neurosurg","first-page":"1043","article-title":"The evolution of the endonasal approach for craniopharyngiomas. 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Clinical article","volume":"119","author":"Koutourousiou","year":"2013"},{"key":"b23-0370012","series-title":"Neurosurgery","first-page":"242","article-title":"Results of microsurgical clipping of 50 high complexity basilar apex aneurysms","volume":"60","author":"Krisht","year":"2007"},{"key":"b24-0370012","series-title":"J Neurosurg","first-page":"1","article-title":"Surgical outcomes of the minimum anterior and posterior combined transpetrosal approach for resection of retrochiasmatic craniopharyngiomas with complicated conditions. Clinical article","volume":"120","author":"Kunihiro","year":"2014"},{"key":"b25-0370012","series-title":"J Neurosurg","first-page":"825","article-title":"Editorial. Extended transsphenoidal approach","volume":"102","author":"Laws","year":"2005"},{"issue":"4","key":"b26-0370012","series-title":"Neurosurg Focus","first-page":"E14","article-title":"Surgical nuances for removal of retrochiasmatic craniopharyngioma via the endoscopic endonasal extended transsphenoidal transplanum transtuberculum approach","volume":"30","author":"Liu","year":"2011"},{"key":"b27-0370012","series-title":"J Neurosurg","first-page":"445","article-title":"The role of transsphenoidal surgery in the treatment of craniopharyngiomas","volume":"100","author":"Maira","year":"2004"},{"key":"b28-0370012","series-title":"Neurosurgery","first-page":"106","article-title":"Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa","volume":"44","author":"Menovsky","year":"1999"},{"key":"b29-0370012","series-title":"Neurosurgery","first-page":"219","article-title":"Endoscope-assisted brain surgery: part 1\u2014evolution, basic concept, and current technique","volume":"42","author":"Perneczky","year":"1998"},{"key":"b30-0370012","series-title":"Childs Nerv Syst","first-page":"669","article-title":"Fronto-basal interhemispheric approach for craniopharyngiomas extending outside the suprasellar cistern","volume":"21","author":"Shirane","year":"2005"},{"key":"b31-0370012","series-title":"World Neurosurg","first-page":"374","article-title":"Endoscopic endonasal transsphenoidal \u201cabove and below\u201d approach to the retroinfundibular area and interpeduncular cistern\u2014cadaveric study and case illustrations","volume":"81","author":"Silva","year":"2014"},{"key":"b32-0370012","series-title":"J Neurosurg","first-page":"55","article-title":"Endocrinological outcome after pituitary transposition (hypophysopexy) and adjuvant radiotherapy for tumors involving the cavernous sinus. Clinical article","volume":"115","author":"Taussky","year":"2011"},{"key":"b33-0370012","series-title":"Neurosurgery","first-page":"1313","article-title":"Microsurgical approaches to the perimesencephalic cisterns and related segments of the posterior cerebral artery: comparison using a novel application of image guidance","volume":"54","author":"Ulm","year":"2004"},{"key":"b34-0370012","series-title":"J Neurosurg","first-page":"3","article-title":"Craniopharyngioma in adults and children: a study of 122 surgical cases","volume":"97","author":"Van Effenterre","year":"2002"},{"key":"b35-0370012","series-title":"Surgery of the Third Ventricle","first-page":"476","article-title":"The transnasal transsphenoidal approach","author":"Weiss","year":"1987"},{"key":"b36-0370012","series-title":"World Neurosurg","first-page":"320","article-title":"Surgical outcome in 90 patients with craniopharyngioma: an evaluation of transsphenoidal surgery","volume":"74","author":"Yamada","year":"2010"},{"key":"b37-0370012","series-title":"J Neurosurg","first-page":"3","article-title":"Total removal of craniopharyngiomas. 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Clinical article","volume":"111","author":"Cavallo","year":"2009"},{"key":"b5-0370012","series-title":"J Neurosurg","first-page":"230","article-title":"Extradural temporopolar approach to lesions of the upper basilar artery and infrachiasmatic region","volume":"81","author":"Day","year":"1994"},{"issue":"5 Suppl 2","key":"b6-0370012","series-title":"Neurosurgery","first-page":"219","article-title":"Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas","volume":"61","author":"de Divitiis","year":"2007"},{"key":"b7-0370012","series-title":"Acta Neurochir (Wien)","first-page":"1213","article-title":"Surgical management of giant craniopharyngiomas","volume":"150","author":"Fahlbusch","year":"2008"},{"key":"b8-0370012","series-title":"J Neurosurg","first-page":"237","article-title":"Surgical treatment of craniopharyngiomas: experience with 168 patients","volume":"90","author":"Fahlbusch","year":"1999"},{"key":"b9-0370012","series-title":"J Neurosurg","first-page":"957","article-title":"Anatomical and quantitative description of the transcavernous approach to interpeduncular and prepontine cisterns. Technical note","volume":"104","author":"Figueiredo","year":"2006"},{"issue":"1 Suppl 1","key":"b10-0370012","series-title":"Neurosurgery","first-page":"ONS75","article-title":"The endoscopic extended transsphenoidal approach for craniopharyngiomas","volume":"59","author":"Frank","year":"2006"},{"key":"b11-0370012","series-title":"J Neurosurg","first-page":"340","article-title":"Zygomatic approach for lesions in the interpeduncular cistern","volume":"62","author":"Fujitsu","year":"1985"},{"key":"b12-0370012","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":"b13-0370012","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"},{"key":"b14-0370012","series-title":"J Neurosurg Pediatr","first-page":"345","article-title":"Modified orbitozygomatic craniotomy for craniopharyngioma resection in children. Clinical article","volume":"4","author":"Golshani","year":"2009"},{"key":"b15-0370012","series-title":"Surg Neurol","first-page":"405","article-title":"Transpetrosal-transtentorial approach and its application in the therapy of retrochiasmatic craniopharyngiomas","volume":"24","author":"Hakuba","year":"1985"},{"key":"b16-0370012","series-title":"J Neurosurg","first-page":"373","article-title":"Results after treatment of craniopharyngiomas: further experiences with 73 patients since 1997. Clinical article","volume":"116","author":"Hofmann","year":"2012"},{"key":"b17-0370012","series-title":"J Neurosurg Pediatr","first-page":"49","article-title":"The transsphenoidal resection of pediatric craniopharyngiomas: a case series. Clinical article","volume":"5","author":"Jane","year":"2010"},{"key":"b18-0370012","series-title":"Clin Endocrinol (Oxf)","first-page":"397","article-title":"Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up","volume":"62","author":"Karavitaki","year":"2005"},{"key":"b19-0370012","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"},{"issue":"3 Suppl 1","key":"b20-0370012","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"},{"key":"b21-0370012","series-title":"Surg Neurol","first-page":"290","article-title":"Extended transsphenoidal surgery for suprasellar craniopharyngiomas: infrachiasmatic radical resection combined with or without a suprachiasmatic translamina terminalis approach","volume":"71","author":"Kitano","year":"2009"},{"key":"b22-0370012","series-title":"J Neurosurg","first-page":"1194","article-title":"Endoscopic endonasal surgery for craniopharyngiomas: surgical outcome in 64 patients. Clinical article","volume":"119","author":"Koutourousiou","year":"2013"},{"key":"b23-0370012","series-title":"Neurosurgery","first-page":"242","article-title":"Results of microsurgical clipping of 50 high complexity basilar apex aneurysms","volume":"60","author":"Krisht","year":"2007"},{"key":"b24-0370012","series-title":"J Neurosurg","first-page":"1","article-title":"Surgical outcomes of the minimum anterior and posterior combined transpetrosal approach for resection of retrochiasmatic craniopharyngiomas with complicated conditions. Clinical article","volume":"120","author":"Kunihiro","year":"2014"},{"key":"b25-0370012","series-title":"J Neurosurg","first-page":"825","article-title":"Editorial. 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Clinical article","volume":"115","author":"Taussky","year":"2011"},{"key":"b33-0370012","series-title":"Neurosurgery","first-page":"1313","article-title":"Microsurgical approaches to the perimesencephalic cisterns and related segments of the posterior cerebral artery: comparison using a novel application of image guidance","volume":"54","author":"Ulm","year":"2004"},{"key":"b34-0370012","series-title":"J Neurosurg","first-page":"3","article-title":"Craniopharyngioma in adults and children: a study of 122 surgical cases","volume":"97","author":"Van Effenterre","year":"2002"},{"key":"b35-0370012","series-title":"Surgery of the Third Ventricle","first-page":"476","article-title":"The transnasal transsphenoidal approach","author":"Weiss","year":"1987"},{"key":"b36-0370012","series-title":"World Neurosurg","first-page":"320","article-title":"Surgical outcome in 90 patients with craniopharyngioma: an evaluation of transsphenoidal surgery","volume":"74","author":"Yamada","year":"2010"},{"key":"b37-0370012","series-title":"J Neurosurg","first-page":"3","article-title":"Total removal of craniopharyngiomas. 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