Abstract
A.B.
Kassam; A.J. Thomas; C. Snyderman; R. Carrau; P. Gardner*; A. Mintz; H.
Kanaan*; M. Horowitz; I.F. Pollack
Objective
The authors reviewed
their experience with endoscopic approaches to determine their safety and
efficacy in the treatment of pediatric patients who harbor skull base lesions.
Although they were interested in ascertaining outcomes after surgery as well as
validating and defining indications and limitations of these approaches, the
authors recognized that the follow-up duration was inadequate to assess
long-term outcomes.
Methods
The authors conducted
a retrospective review of all endoscopic procedures performed at their
institution between January 2000 and September 2005. The procedures were
categorized into a series of anatomical modular approaches. Twenty-five
patients 18 years of age or younger were identified. The surgical goals were
individualized and included gross-total resection, partial resection, biopsy,
decompression of neural structures, and repair of a cerebrospinal fluid (CSF)
leak. One patient required an open procedure in addition to the expanded
endonasal approach for definitive therapy. No patient suffered a neurological
deficit, vascular injury, or central nervous system infection. A CSF leak was
the most common complication and occurred in two (8%) of the 25 patients.
Conclusions
In well-selected
patients, the expanded endonasal approach represents a safe, effective, and
minimally invasive technique for the treatment of skull base lesions in
children. Incremental experience is needed for acquiring the skills with
endoscopic techniques to progress to the more complex modular approaches.