Expertise at Lariboisiere

The Lariboisière neurosurgery team has all modern equipment in the operating room (endoscope, microscope, neuronavigation, cranial nerve monitoring, intraoperative CT scan). The team masters all surgical techniques for the optimal management of these complex tumors. Its expertise is internationally recognized, as evidenced by the following recent publications ¹–⁶

Our team participated in the drafting of the National Consensus for the management of craniopharyngiomas, writing the chapter on surgical treatment⁷. We recently published an article in the Journal of Clinical Endocrinology and Metabolism (a major international endocrinology journal), reporting our management strategy for adult craniopharyngiomas⁶. This strategy is based on the tumor’s relationship with the hypothalamus:

  • For tumors located below the hypothalamus (type A tumors) or crossing the hypothalamus (type B tumors), the endoscopic endonasal approach is most often indicated. This procedure is effective and safe in the vast majority of cases, with a high rate of visual improvement (90%) and a low rate of surgery-induced hypothalamic dysfunction (<5%).
  • For the rare tumors located above the hypothalamus (type C tumors), the endonasal approach is not indicated. Surgery is then associated with a higher risk. However, in adults, a significant proportion of these type C tumors are mutated papillary craniopharyngiomas, and thus sensitive to targeted therapy. In this situation, we therefore increasingly propose a simple biopsy to confirm the mutation, prior to targeted therapy that replaces surgical resection, followed by radiotherapy. The initial results published as part of a national collaborative effort in which we participated are promising⁸.

Our expertise is recognized, as evidenced by the 12 adult and/or pediatric Multidisciplinary Team Meetings (MDT) we participate in. These MDTs, usually monthly, allow for the discussion of craniopharyngioma cases in a collegial manner, in order to make the best possible decision for each patient:

  • 8 Ile de France Endocrinology MDTs in expert endocrinology centers (Dr. Baussart)
  • 2 Local and National Skull Base MDTs (Prof. Froelich)
  • 1 Regional Radiotherapy MDT (Prof. Assié, Dr. Baussart)
  • 1 National CranioCare Craniopharyngioma MDT (led by Prof. Jouanneau and Dr. Baussart).

Finally, as with skull base and pituitary tumors, the Lariboisière adult neurosurgery department collaborates with the Necker pediatric neurosurgery department (Prof. Blauwblomme, Prof. Beccaria) for the surgical management of craniopharyngiomas on the one hand, and to ensure a smooth patient pathway during the child–adult transition on the other. Due to our expertise in endoscopic endonasal surgery, Prof. Froelich and Dr. Baussart collaborate with Prof. Beccaria to operate on some of these tumors at the Necker pediatric hospital site. More recently (June 2025), a bimonthly AYA (Adolescent and Young Adult) MDT has been set up with the Institut Gustave Roussy (Dr. Dufour, Dr. Grill), in which the Lariboisière neurosurgery department participates for its expertise in the sellar and suprasellar region (Dr. Baussart, Dr. Abbritti).

  1. Baussart B, Declerck A, Gaillard S. Mononostril endoscopic endonasal approach for pituitary surgery. Acta Neurochir. 2021;163(3):655-659. doi:10.1007/s00701-020-04542-z
  2. Laurent C, Gaillard S, Baussart B. Expanded endoscopic endonasal approach for the resection of midline craniopharyngiomas with hypothalamic involvement. Acta Neurochir (Wien). 2022;164(12):3291-3296. doi:10.1007/s00701-022-05387-4
  3. Labidi M, Watanabe K, Hanakita S, et al. The Chopsticks Technique for Endoscopic Endonasal Surgery-Improving Surgical Efficiency and Reducing the Surgical Footprint. World Neurosurg. 2018;117:208-220. doi:10.1016/j.wneu.2018.05.229
  4. Wang EW, Zanation AM, Gardner PA, et al. ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol. 2019;9(S3):S145-S365. doi:10.1002/alr.22326
  5. Labidi M, Watanabe K, Loit MP, Hanakita S, Froelich S. The Posterior Transpetrosal Approach in a Case of Large Retrochiasmatic Craniopharyngioma: Operative Video and Technical Nuances. J Neurol Surg B Skull Base. 2018;79(2):S205-S207. doi:10.1055/s-0037-1620252
  6. Gaillard S, Benichi S, Villa C, et al. Prognostic Impact of Hypothalamic Perforation in Adult Patients With Craniopharyngioma: A Cohort Study. J Clin Endocrinol Metab. 2024;109(8):2083-2096. doi:10.1210/clinem/dgae049
  7. Cuny T, Buchfelder M, Dufour H, et al. The Challenging Management of Craniopharyngiomas in Adults: Time for a Reappraisal? Cancers (Basel). 2022;14(15):3831. doi:10.3390/cancers14153831
  8. Dario De Alcubierre, Grigorios Gkasdaris, Margaux Mordre, Anthony Joncour, Claire Briet, Fabien Almairac, Julien Boetto, Celine Mouly, Delphine Larrieu-Ciron, Alexandre Vasiljevic, Chiara Villa, Camille Sergeant, François Ducray, Loic Feuvret, Philippe Chanson, Bertrand Baussart, Gerald Raverot, Emmanuel Jouanneau. Article:B-RAF and MEK inhibitor targeted therapy in papillary craniopharyngiomas: A cohort study. European Journal of Endocrinology. doi:10.1093/ejendo/lvae091