{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:09:30Z","timestamp":1753891770911,"version":"3.41.2"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T00:00:00Z","timestamp":1666915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The management of retroinfundibular craniopharyngioma (CP) remains the ultimate challenge for both transsphenoidal and open transcranial surgery because of their anatomical location and proximity to vital neurovascular structures. In this report, we aim to describe the technique and feasibility of a novel approach, the purely endoscopic far-lateral supracerebellar infratentorial approach (EF-SCITA), for resection of retroinfundibular CP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description<\/jats:title><jats:p>A 63-year-old women presented with progressive visual disturbance, polyuria, and spiritlessness of a 3-month duration. Imaging studies revealed a typical retroinfundibular CP containing solid and cystic components with calcification, which extended inferiorly in front of the brainstem and upward into the third ventricle. The EF-SCITA approach was attempted for resection of the tumor. During surgery, lateral prone positioning with upper flexion of the head and early CSF release allowed for download retraction of the cerebellum. This, in combination with tentorium incision, created a working corridor toward retrosellar and suprasellar spaces. This approach required working between neurovascular structures in the crural cistern, with tumor removal permitted in supra-oculomotor and infra-oculomotor spaces. After aspiration of the fluid contents through the supra-oculomotor triangle, the solid lesion was found tightly adhering to the distal part of the pituitary stalk, and subtotal resection was achieved for maintaining the integrity of pituitary function. In the immediate postoperative period, the patients exhibited oculomotor paralysis and was discharged with hormonal replacement therapy three weeks after operation. At her three-month follow-up appointment, she reported obvious vision improvement. Physical examinations showed partial alleviation of oculomotor\u00a0paralysis. Pathological analyses confirmed the diagnosis of papillary CP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The purely EF-SCITA approach combines the advantages of both the posterolateral approach and endoscopic technique, which offers access to retrosellar and suprasellar spaces with seemingly low risks of postoperative morbidity. It would be a safe and effective alternative for the treatment of retroinfundibular CP, especially those with lateral extension to the temporal lobe or posterolateral extension to the petroclival region. Further observational studies in a larger cohort are urgently needed to assess the long-term efficacy of this minimal access approach.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2022.976737","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T13:14:56Z","timestamp":1666962896000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case report and literature review: Resection of retroinfundibular craniopharyngioma via endoscopic far-lateral supracerebellar infratentorial approach"],"prefix":"10.3389","volume":"12","author":[{"given":"Yang","family":"Bai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyu","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinning","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guobiao","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sizhe","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunyong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,28]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","DOI":"10.1210\/er.2013-1115","article-title":"Craniopharyngioma","volume":"35","author":"M\u00fcller","year":"2014","journal-title":"Endocr Rev"},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.1007\/s11060-009-9841-4","article-title":"Surgical management of craniopharyngiomas","volume":"92","author":"Komotar","year":"2009","journal-title":"J Neuro Oncol"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1097\/00006123-199412000-00001","article-title":"Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome","volume":"35","author":"Weiner","year":"1994","journal-title":"Neurosurgery"},{"key":"B4","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3171\/jns.1992.76.1.0047","article-title":"Aggressive surgical management of craniopharyngiomas in children","volume":"76","author":"Hoffman","year":"1992","journal-title":"J Neurosurg"},{"key":"B5","doi-asserted-by":"crossref","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"},{"key":"B6","doi-asserted-by":"crossref","DOI":"10.1002\/hed.21771","article-title":"Craniopharyngioma: a pathologic, clinical, and surgical review","volume":"34","author":"Fernandez-Miranda","year":"2012","journal-title":"Head Neck"},{"key":"B7","doi-asserted-by":"crossref","DOI":"10.3171\/2010.1.FOCUS09309","article-title":"Surgical nuances for removal of retrochiasmatic craniopharyngiomas via the transbasal subfrontal translamina terminalis approach","volume":"28","author":"Liu","year":"2010","journal-title":"Neurosurg Focus"},{"key":"B8","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"},{"key":"B9","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":"Ya\u015fargil","year":"1990","journal-title":"J Neurosurg"},{"key":"B10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3171\/jns.2002.97.1.0003","article-title":"Craniopharyngioma in adults and children: a study of 122 surgical cases","volume":"97","author":"Van Effenterre","year":"2002","journal-title":"J Neurosurg"},{"key":"B11","doi-asserted-by":"crossref","DOI":"10.3171\/jns.1992.76.6.1032","article-title":"The Krause operations","volume":"76","author":"Rosegay","year":"1992","journal-title":"J Neurosurg"},{"key":"B12","article-title":"Endoscopic far-lateral supracerebellar infratentorial approach for petroclival region meningioma: Surgical technique and clinical experience","volume":"22","author":"Xie","year":"2022","journal-title":"Operative Neurosurg (Hagerstown Md)"},{"key":"B13","doi-asserted-by":"crossref","DOI":"10.1007\/s12264-010-1036-7","article-title":"A young and booming approach: the extreme lateral supracerebellar infratentorial approach","volume":"26","author":"Chen","year":"2010","journal-title":"Neurosci Bull"},{"key":"B14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.wneu.2020.12.042","article-title":"Extreme lateral supracerebellar infratentorial approach: Surgical anatomy and review of the literature","volume":"147","author":"Giammattei","year":"2021","journal-title":"World Neurosurg"},{"key":"B15","doi-asserted-by":"crossref","DOI":"10.1007\/s00701-019-03886-5","article-title":"Extreme lateral supracerebellar infratentorial approach: how I do it","volume":"161","author":"Giammattei","year":"2019","journal-title":"Acta Neurochirurgica"},{"key":"B16","first-page":"640","article-title":"Endoscope-assisted extreme lateral supracerebellar infratentorial approach for resection of superior cerebellar peduncle pilocytic astrocytoma: Technical note","volume":"9","author":"Papadimitriou","year":"2022","journal-title":"Children (Basel Switzerland)"},{"key":"B17","doi-asserted-by":"crossref","DOI":"10.3171\/2015.3.JNS142254","article-title":"Comparative analysis of outcomes following craniotomy and expanded endoscopic endonasal transsphenoidal resection of craniopharyngioma and related tumors: a single-institution study","volume":"124","author":"Jeswani","year":"2016","journal-title":"J Neurosurg"},{"key":"B18","doi-asserted-by":"crossref","DOI":"10.1016\/j.wneu.2019.04.146","article-title":"The purely endoscopic supracerebellar infratentorial approach for resecting pineal region tumors with preservation of cerebellomesencephalic vein: Technical note and preliminary clinical outcomes","volume":"128","author":"Gu","year":"2019","journal-title":"World Neurosurg"},{"key":"B19","doi-asserted-by":"crossref","DOI":"10.3171\/2010.1.FOCUS09292","article-title":"Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas","volume":"28","author":"Campbell","year":"2010","journal-title":"Neurosurg Focus"},{"key":"B20","doi-asserted-by":"crossref","DOI":"10.3171\/2009.2.JNS081026","article-title":"Extended endoscopic endonasal transsphenoidal approach for residual or recurrent craniopharyngiomas","volume":"111","author":"Cavallo","year":"2009","journal-title":"J Neurosurg"},{"key":"B21","doi-asserted-by":"crossref","DOI":"10.3171\/jns.2007.106.3.400","article-title":"Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions","volume":"106","author":"Laufer","year":"2007","journal-title":"J Neurosurg"},{"key":"B22","article-title":"Expanded endonasal approach: the rostrocaudal axis. Part i. crista galli to the sella turcica","volume":"19","author":"Kassam","year":"2005","journal-title":"Neurosurg Focus"},{"key":"B23","first-page":"991","article-title":"Endoscopic cranial base surgery: classification of operative approaches","volume":"62","author":"Schwartz","year":"2008","journal-title":"Neurosurgery"},{"key":"B24","first-page":"57","article-title":"Endoscopic endonasal pituitary transposition for a transdorsum sellae approach to the interpeduncular cistern","volume":"62","author":"Kassam","year":"2008","journal-title":"Neurosurgery"},{"key":"B25","doi-asserted-by":"crossref","DOI":"10.1227\/01.NEU.0000339121.20101.85","article-title":"Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations","volume":"64","author":"Dehdashti","year":"2009","journal-title":"Neurosurgery"},{"key":"B26","first-page":"94","article-title":"Transsphenoidal approaches for the extracapsular resection of midline suprasellar and anterior cranial base lesions","volume":"49","author":"Kaptain","year":"2001","journal-title":"Neurosurgery"},{"key":"B27","article-title":"Extended endoscopic transsphenoidal approach for tuberculum sellae meningiomas","volume":"61","author":"de Divitiis","year":"2007","journal-title":"Neurosurgery"},{"key":"B28","doi-asserted-by":"crossref","DOI":"10.3171\/2010.11.JNS10670","article-title":"Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series","volume":"114","author":"Mortini","year":"2011","journal-title":"J Neurosurg"},{"key":"B29","doi-asserted-by":"crossref","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"},{"key":"B30","article-title":"The petrosal approach for the resection of retrochiasmatic craniopharyngiomas","volume":"62","author":"Al-Mefty","year":"2008","journal-title":"Neurosurgery"},{"key":"B31","doi-asserted-by":"crossref","DOI":"10.3171\/foc.2005.18.6.10","article-title":"Cranial base strategies for resection of craniopharyngioma in children","volume":"18","author":"Liu","year":"2005","journal-title":"Neurosurg Focus"},{"key":"B32","doi-asserted-by":"crossref","DOI":"10.3171\/jns.1996.84.6.0951","article-title":"Bifrontal basal interhemispheric approach to craniopharyngioma resection with or without division of the anterior communicating artery","volume":"84","author":"Shibuya","year":"1996","journal-title":"J Neurosurg"},{"key":"B33","doi-asserted-by":"crossref","DOI":"10.1016\/0090-3019(89)90197-3","article-title":"A pitfall in the interhemispheric translamina terminalis approach for the removal of a craniopharyngioma. significance of preserving draining veins. part i. clinical study","volume":"32","author":"Kanno","year":"1989","journal-title":"Surg Neurol"},{"key":"B34","doi-asserted-by":"crossref","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"},{"key":"B35","article-title":"Far lateral supracerebellar infratentorial approach for the treatment of upper brainstem gliomas: clinical experience with pediatric patients","volume":"21","author":"Vougioukas","year":"2005","journal-title":"Child's Nervous System: ChNS: Off J Int Soc Pediatr Neurosurg"},{"key":"B36","article-title":"A fetal-type variant posterior communicating artery and its clinical significance","volume":"11","author":"Capone","year":"2019","journal-title":"Cureus"},{"key":"B37","doi-asserted-by":"crossref","first-page":"88","DOI":"10.4103\/2152-7806.74147","article-title":"A review of the management of posterior communicating artery aneurysms in the modern era","volume":"1","author":"Golshani","year":"2010","journal-title":"Surg Neurol Int"},{"key":"B38","doi-asserted-by":"crossref","DOI":"10.1007\/s00234-020-02489-7","article-title":"Rare neurovascular conflict between oculomotor nerve and posterior communicating artery","volume":"62","author":"Giannantoni","year":"2020","journal-title":"Neuroradiology"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.976737\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T13:15:38Z","timestamp":1666962938000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.976737\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,28]]},"references-count":38,"alternative-id":["10.3389\/fonc.2022.976737"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2022.976737","relation":{},"ISSN":["2234-943X"],"issn-type":[{"type":"electronic","value":"2234-943X"}],"subject":[],"published":{"date-parts":[[2022,10,28]]},"article-number":"976737"}}