Affordable Access

deepdyve-link
Publisher Website

Charles H. Frazier's craniopharyngioma treatment: the pivotal role of the transfrontal approach.

Authors
  • Prieto, Ruth1
  • Pascual, José María2
  • Barrios, Laura3
  • 1 1Department of Neurosurgery, Puerta de Hierro University Hospital.
  • 2 2Department of Neurosurgery, La Princesa University Hospital; and.
  • 3 3Statistics Department, Computing Center, CSIC, Madrid, Spain. , (Spain)
Type
Published Article
Journal
Journal of Neurosurgery
Publisher
Journal of Neurosurgery Publishing Group
Publication Date
Nov 08, 2019
Pages
1–14
Identifiers
DOI: 10.3171/2019.8.JNS191508
PMID: 31703208
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Charles H. Frazier (1870-1936), one of the pioneers of neurosurgery in the US, is known worldwide for devising surgical procedures to relieve trigeminal neuralgia and intractable pain. Less well-known are his substantial contributions to understanding and treating pituitary and parahypophyseal lesions. Along with Bernard Alpers, he defined Rathke's cleft tumors as a different pathological entity from adenomas and hypophyseal stalk tumors (craniopharyngiomas [CPs]). The surgical challenge posed by CPs piqued Frazier's interest in these lesions, although he never published a complete account of his CP series. An examination of the Charles Frazier papers at the College of Physicians of Philadelphia allowed the authors to identify 54 CPs that he had treated during his career. In the early 1910s, Frazier developed the subfrontal approach, which would become the primary surgical route to access these lesions, providing better control of the adjacent vital neurovascular structures than the transsphenoidal route hitherto used. Nevertheless, strong adhesions between CPs and the third ventricle floor, the major reason underlying Frazier's disappointing results, moved him to advocate incomplete tumor removal followed by radiotherapy to reduce both the risk of hypothalamic injury and CP recurrence. This conservative strategy remains a judicious treatment for CPs to this day.

Report this publication

Statistics

Seen <100 times