Extended endoscopic endonasal approach for the resection of third ventricular craniopharyngiomas: A technical case report

Background: ThThe surgical treatment of third ventricular craniopharyngiomas (CPs) is challenging due to their deep location and proximity to critical neurovascular structures. This report presents the use of the extended endoscopic endonasal approach for the resection of a third ventricular CP. Case Description: A 48-year-old male patient was admitted to the hospital with visual disturbances and weight gain (body mass index 42.6 kg/m2) over the past 12 months. Preoperative contrast-enhanced magnetic resonance imaging revealed a 30-mm solid mass located within the third ventricle. The patient underwent an extended endoscopic endonasal transplanum transtuberculum approach, providing direct access to the tumor. The postoperative period was uneventful, with no cerebrospinal fluid (CSF) leakage observed. Conclusion: The extended endoscopic endonasal approach is a safe and effective technique for the resection of suprasellar and third ventricular CPs, offering direct access while avoiding brain retraction. Dural suturing plays a key role in skull base reconstruction, reducing the risk of postoperative CSF leakage.