Endoscopic Transnasal Skull Base Surgery in Pediatric Patients

Gokmen Kahilogullari; Cem Meco; Suha Beton; Murat Zaimoglu; Onur Ozgural; Hazan Basak; Melih Bozkurt; Agahan Unlu

doi:10.1055/s-0039-1692641

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2020; 81(05): 515-525
DOI: 10.1055/s-0039-1692641

Original Article

Endoscopic Transnasal Skull Base Surgery in Pediatric Patients

Authors

Gokmen Kahilogullari

¹Department of Neurosurgery, Ankara University, Ankara, Turkey
Cem Meco^*

²Department of Otolaryngology, Ankara University, Turkey

³Department of Otolaryngology, Salzburg Paracelsus Medical University, Salzburg, Austria
Suha Beton^*

²Department of Otolaryngology, Ankara University, Turkey
Murat Zaimoglu^*

¹Department of Neurosurgery, Ankara University, Ankara, Turkey
Onur Ozgural^*

¹Department of Neurosurgery, Ankara University, Ankara, Turkey
Hazan Basak^*

²Department of Otolaryngology, Ankara University, Turkey
Melih Bozkurt^*

¹Department of Neurosurgery, Ankara University, Ankara, Turkey
Agahan Unlu^*

¹Department of Neurosurgery, Ankara University, Ankara, Turkey

Abstract

Introduction In pediatric patients, endoscopic transnasal surgery (ETNS) poses challenges because of the small size of the developing skull and narrow endonasal corridors.

Objective This study aimed to evaluate the efficacy of ETNS in children by assessing our experience of endoscopic skull base surgery.

Materials and Methods All pediatric patients (n = 54) who were eligible for surgery using only the endonasal endoscopic approach at our tertiary center between 2012 and 2018 were included in this study. The surgeries were performed simultaneously by an endoscopic skull base team of neurosurgeons and otolaryngologists. Hormonal analyses were conducted before and after surgery in all patients with sellar/parasellar lesions. Patients older than 8 years underwent smell and visual testing.

Results In the 54 patients aged 1 to 17 years who underwent surgery, craniopharyngioma was the most common pathology (29.6%), followed by pituitary adenoma (22.2%). Gross total resection was achieved in 33 (76.7%) of 41 patients who underwent surgery because of the presence of tumors. All visual deficits improved, although one patient sustained olfactory deterioration. Sixteen (29.6%) patients presented with complications such as transient diabetes insipidus and temporary visual loss.

Conclusions Despite anatomy-related challenges in children, adequate results can be achieved with high rates of success, and the functional and anatomical integrity of the developing skull and nose of children can be preserved. In pediatric patients, ETNS is a safe and effective option for addressing various lesions along the skull base.

Keywords

endoscopic - pediatric - skull base - surgery - endonasal - transsphenoidal

Full Text

References

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