Excision of pediatric craniopharyngioma with complicated features: the value of additional "tailored" cavernous sinus exposure in the standard pterional approach.
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Excision of craniopharyngioma (CP) can be challenging. Pediatric CPs pose the unique challenge of ensuring a satisfactory onco-functional balance while navigating the limited therapeutic options in this age group. Here the authors present the value of "tailored" cavernous sinus exposure and neurovascular mobilization to minimize the inevitable and, at times, potentially harmful manipulation of the optic and oculomotor nerves associated with an anterolateral transcranial approach. This additional surgical step also ensures an inferior-to-superior surgical trajectory through a caudal durotomy, significantly improving the tumor-hypothalamus interface visualization, which is otherwise a limitation of the pterional approach. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID25239.