Extended endoscopic endonasal approach for resection of a craniopharyngioma in a patient with sphenoid sinus fibrous dysplasia

Abstract

This video demonstrates a stepwise endoscopic endonasal strategy for the management of a cystic suprasellar craniopharyngioma coexisting with extensive sphenoid fibrous dysplasia in a 55-year-old man presenting with visual deterioration and neuroendocrine dysfunction. Severe distortion of the sphenoid anatomy required progressive neuronavigation-guided drilling and reconstruction of critical skull base landmarks to safely reestablish the surgical corridor. This strategy enabled successful tumor resection and bilateral optic nerve decompression while preserving the advantages of the endoscopic endonasal route. The technique may be applicable to other complex sphenoid anatomies, including conchal sphenoid sinus variants, when this approach represents the optimal corridor for resection. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID26144