Introduction: Endoscopic endonasal transphenoidal approaches to craniopharyngiomata has become increasingly popular over the last 15 years. In select patients this procedure that can be performed with ease of access and with minimal morbidity. Currently, only few published reports of this approach are in the literature to date and generally these are restricted to large high volume endoscopic centres. We present the results of our retrospective series of craniopharyngiomata resected by an endoscopic, endonasal approach.

Methods: From 2011 to 2015, all patients undergoing pure endoscopic endonasal transsphenoidal resection for a craniopharyngioma at our institution were included. The medical records, histopathology, intraoperative findings and imaging were retrospectively assessed.

Results: From 2011 to 2015 7 patients were assessed with 4 male and 3 female patients. The mean age was 37.6 years (range 14-68 years). Of this patient series a gross total resection of the tumour was achieved in all 7 patients (100%). In the immediate postoperative phase 6 of the 7 patients developed diabetes insipidus (85%). Three of these patients still had confirmed diabetes insipidus at the first follow-up period (43%). Five (71%) of the 7 patients had a diagnosis of panhypopituitarism with one resolving over the duration of follow-up. All patients presented with a degree of visual deficit. 3 patients (43%) had noted an improvement to their presenting visual symptoms. No patients developed a cerebrospinal fluid leak postoperatively.

Conclusions: For selected tumours the endoscopic endonasal transsphenoidal approach for excision of craniopharyngioma can achieve adequate decompression of critical structures and attain high rates of gross total resection and disease control. This endoscopic endonasal approach offers superior visualisation and negates the need for brain retraction in patients with predominantly midline tumours. Our patient series demonstrates the feasibility of this approach with the longest follow-up period published to date.

Patient Care: Our research demonstrates the feasibility and safety of the endoscopic endonasal approach to craniopharyngiomata. We provide further evidence to assist in better patient selection for this procedure.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Understand the indications and utility of the endonasal endoscopic approach to craniopharyngiomata 2) To describe the New Zealand Wellington experience of craniopharyngiomata 3) To understand that excellent outcomes with high degrees of excision can be achieved in non high volume endoscopic skull-base centres

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