Objective The indications,operative techniques and precautions of extended transsphenoidal approach for pediatric craniopharyngioma were studied.Methods The clinical data of 6 cases with craniopharyngioma who operated via extended transsphenoidal approach were analyzed retrospectively,including the clinical symptoms,images,complications and the follow-up data.Results The average age of 6 cases was 10.7 years old,and all of them were diagnosed by CT and MRI.The main clinical symptoms were headache,decreased vision,and retardation.After operation,5 primary and 1 recurrent tumors were completely resected without death.Postoperative cerebrospinal fluid leakage occurred in 1 case,intracranial infection in 1 case,hypopituitarism in 2 cases and diabetes insipidus in 3 cases.There were 1 case of hypopituitarism,1 case of diabetes insipidus and no recurrence cases within a long term (＞ 1 month).Conclusion Extended transsphenoidal approach for the removal of pediatric craniopharyngioma is feasible,but it requires a higher surgical skill and a longer learning curve.Craniopharyngioma under the sellar diaphragm is the best surgical indication.%目的 探讨扩大经蝶入路切除儿童颅咽管瘤的手术适应症、手术技巧及注意事项.方法 回顾性分析采用扩大经蝶入路手术的6例儿童颅咽管瘤患儿的临床资料,包括临床症状、影像、并发症及随访资料等.结果 6例患儿平均年龄10.7岁,均经CT及MRI确诊,主要临床症状为:头痛、视力下降,发育迟缓等.术后5例原发、1例复发性肿瘤均做到内镜下完全切除,无死亡病例.术后近期脑脊液漏1例,颅内感染1例,垂体功能低下2例,尿崩3例.远期(＞1个月)垂体功能低下1例,尿崩1例,无复发病例.结论 扩大经蝶入路切除儿童颅咽管瘤临床可行,但需要较高的手术技巧及较长时间的学习曲线.鞍膈下型颅咽管瘤为最佳手术适应症.
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