Supraorbital Subfrontal Translaminar Endoscope-Assisted Approach for Tumors of the Posterior Third Ventricle: Our Preliminary Experience

Introduction: Different surgical approaches have been developed for dealing with third ventricle lesions all aimed at obtaining a safe removal minimizing brain manipulation. The supraorbital subfrontal translamina terminalis route, commonly employed only for the anterior third ventricle, could represent, in selected cases with endoscopic assistance, an alternative approach for posterior third ventricular lesions.

Methods: Ten patients underwent a supraorbital subfrontal trans-laminar endoscope-assisted approach for posterior third ventricle tumors (four craniopharyngiomas, one papillary tumor of the pineal region, three neurocytomas, two high-grade gliomas). Moreover, a conventional third ventriculostomy was performed via the same translaminar approach in four cases.

Results: Complete tumor removal was accomplished in seven cases, subtotal removal in two cases, and a simple biopsy was performed in one case. Adjuvant radiotherapy and/or chemotherapy was administered, if required, on the basis of the histological diagnosis. No major complications occurred after surgery except for an intratumoral hemorrhage in a patient undergoing a biopsy for a high-grade glioma, which delayed the beginning of adjuvant radiochemotherapy. No ventriculoperitoneal shunt placement was needed in these patients at the most recent clinical and radiological session (average: 39.57 months, range: 13–85 months).

Conclusion: The supraorbital subfrontal translaminar endoscope-assisted approach may provide, in selected cases, an efficient and safe route for dealing with posterior third ventricular tumors.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
15 February 2022