Although both adult and pediatric craniopharyngiomas are called craniopharyngiomas, they are somewhat different in their pathological nature. There are two types of craniopharyngioma pathology: an enamel cell type tumor and a squamous epithelial type tumor. Children tend to have enamel cell type tumors and adults tend to have squamous epithelial type tumors. There is no major difference between adult craniopharyngioma and pediatric craniopharyngioma in terms of location, but in terms of pathology, there is some difference. If the tumor is purely in the saddle, regardless of its pathology, we tend to use the pterygoid or inferior frontal approach. If the tumor grows into the third ventricle or above the base of the third ventricle, then we tend to prefer the transendocampal approach. Strictly speaking, there is not much basis for choosing the surgical approach for adult and pediatric craniopharyngioma according to the age classification. Differences in intraoperative resection of craniopharyngioma During the intraoperative resection of craniopharyngioma, pediatric craniopharyngioma is relatively short-lived in the brain because of its young age, and the adhesions to the surrounding structures are not particularly heavy. For example, in a six-year-old child, the tumor stays in the skull for at most six years, or two to three years. In adult craniopharyngioma, for example, at the age of forty, it may be more than two years, it may be five, six, seven or more than ten years. And the longer the craniopharyngioma grows, the more involvement or invasion or adhesion to the surrounding area, so adult craniopharyngioma is relatively more difficult to operate on than pediatric craniopharyngioma. The above is the difference between adult craniopharyngioma and pediatric craniopharyngioma during surgery, I hope it will be helpful for you. Professor Shi Xiangen of Beijing Sanbo Brain Hospital Craniopharyngioma Specialized Group has been studying the surgical treatment of craniopharyngioma since 1995. His paper “Experience of 309 cases of surgical resection of craniopharyngioma” was published in European Journal of Neurosurgery in 2008; in 2011, he was considered as the best surgeon in terms of the number of surgical cases, total tumor resection rate and surgical effect in the American Journal of Neurosurgery in the evaluation of 7 global research reports on surgical resection of craniopharyngioma with more than 100 cases. In 2011, he was published in the American Journal of Neurosurgery.