Surgical management of craniopharyngiomas in the pediatric population.

BACKGROUND Craniopharyngiomas (CPs) are benign, locally aggressive neoplasms that comprise approximately 10% of pediatric brain tumors. The role of surgical management for CPs is discussed in this review. METHODS A review of the goals and techniques associated with selected surgical approaches for the treatment of CPs in the pediatric population is provided. RESULTS CPs may be a cause of significant morbidity in children, requiring long-term, multimodal management by a team of specialists in order to optimize patient outcomes. Surgical intervention for CPs remains an important component of treatment, and depends upon establishing realistic and well-defined goals prior to any operation. Many transcranial and transsphenoidal approaches are available for approaching and resecting CPs. A summary of the rationale behind the timing and appropriateness of various surgical approaches, as well as associated benefits, pitfalls, and outcomes, is provided in this review. CONCLUSION Consistent longitudinal management by an interdisciplinary team can alter the treatment course in patients with CPs from a debilitating, morbid or lethal condition to a chronic, survivable disease with functional adult livelihood. Excellent outcomes in children with CPs are obtained only by close, frequent monitoring and by developing a keen sense of judgment regarding the appropriateness, timing and aggressiveness of any particular intervention.