• 53-year-old male
• Progressive visual loss for 6 weeks
• Bitemporal hemianopsia, reduced visual acuity of RT eye
• MR scan: suprasellartumour displacing the optic chiasm upwards, appearance of craniopharyngioma
• Transnasal transphenoidal endoscopic total resection
• Histology: craniopharyngioma
• Vision improved to normal within 3 months

Equipment Used

• Storz 0° and 30° 4 mm rod lens endoscope

Surgical Tips

• Endonasal transtuberculum-transplanum (transphenoidal) approach
• Two-nostril approach
• Total tumour removal with pituitary stalk preservation
• Repair of sellar floor with fat, nasoseptal flap, fibrin glue and tamponade for 5 days