显微外科技术的发展、影像学的进步、激素替代疗法的完善,使颅咽管瘤的疗效有了很大提高,但其远期预后、对并发症和死亡率的控制仍不令人满意,尤其在肿瘤的切除原则、手术入路的选择、术后放疗与否、垂体柄的保留等问题上存在着较大分歧。1 颅咽管瘤的外科学分型 根据肿瘤的位置和生长方式,Rougerie于1962年首先提出了颅咽管瘤的外科学分型,将颅咽管瘤分为5型:鞍内型、鞍内-鞍上向前扩展型、视交叉后型、巨大型、不典型型。1980年,Ciric将颅咽管瘤分为脑室内型、软脑膜下型、软脑膜外蛛网膜下型、蛛网膜内外型(哑铃型)、蛛网膜外型(单纯鞍内型)。1983年,Konovalov将颅咽管瘤分为鞍内型、鞍上 The development of microsurgery, the progress of imaging and the improvement of hormone replacement therapy have greatly improved the curative effect of craniopharyngioma, but its long-term prognosis and the control of complications and mortality are still unsatisfactory , Especially in the tumor excision principle, the choice of surgical approach, postoperative radiotherapy, pituitary stalk preservation and other issues there is a big difference. Surgical classification of craniopharyngioma According to the location and growth of the tumor, Rougerie first proposed the surgical classification of craniopharyngioma in 1962. The craniopharyngiomas were divided into 5 types: saddle type, saddle type Internal - saddle forward expansion type, after the optical cross-type, huge, atypical. In 1980, Ciric divided craniopharyngiomas into intracerebroventricular type, subdural type, extradural subarachnoid type, arachnoid type (dumbbell type) and arachnoid shape (simple saddle type). In 1983, Konovalov divided craniopharyngiomas into saddle type, suprasellar