Introduction: For    neurosurgeons,     the             most difficult problems        are craniopharyngiomas. This disease – look like a rare with low histological degree – embryonic malformations of the selar and paraselar area, the prevalence of the tumor is 2/100 000. 

Aim: Bring    to    an    improved    level    the    results    of    treatment    with craniopharingioma – a method of selective use of various surgical treatments.

Materials and object of research: An analysis of the literature was performed, which contained information about the patients who underwent surgery and their results of surgical interventions was performed. The average age of patients was 37.6 years. Supraselar component in the majority have 94-95% (above the turkish saddle is located purely occupies 20-41%, and extra – intrasellar (53-75 %). In one study (3.2%), it was noted that the tumor occupied several adjacent anatomical areas. Endoscopic transsphenoidal access provides a better degree of resection with minimal postoperative neurological manifestations, so this method is an alternative to craniotomy.

Results: The work was analyzed, in which it was found that 86.5% of patients experienced treatment as a general resection of craniopharyngioma through transcranial access. Another 13.5% of patients underwent subtotal craniopharyngioma removal. In 5% of patients during follow-up for 360 – 913 days, further growth of the residual tumor was recorded, 3% of whom underwent surgery and then radiation therapy. During their first operation, if we do not take into account the total resection of the tumor, then 3% of patients had a recurrence within 450 – 1034 days. After analyzing the results of supraselar injury, including its treatment for fiftythree operations, nineteen were treated with endoscopic endonasal transsphenoidal surgery and thirty-four with craniotomy. The size of the resection was the same between the 2 groups (74.5% EETS: 80.6% craniotomy, p = 0.66). Patients in the craniotomy group showed an increase in the incidence of cranial nerve damage (0% EETS versus 33.6% craniotomy, p = 0.06). Recurrences (32.2% EETS vs. 43.5% craniotomy) and survival curves were the same between group 2. 

Conclusions: It can be concluded with respect to surgical treatment of craniopharyngiomas that treatment requires a differentiated approach. To ensure overall or maximum safety resection, endoscopic endonasal transsphenoidal surgery may be used for each craniopharyngioma, regardless of size, location, and enlargement.