Pediatric Endonasal Endoscopic Skull Base Surgery: An Institutional Experience of 54 Patients

Objective: Endonasal endoscopic approach to the skull base in pediatric age group could be challenging. Our aim is to discuss its advantages and disadvantages.

Methods: Retrospective analysis of 54 pediatric patients who are operated purely via endonasal endoscopic approach in Ankara University between 2012 and 2018 were done.

Results: Thirty-three patients (61.1%) were male and 21 were female (38.8%). The main age was 10.4 (1–17). Sixteen cases had craniopharyngioma (29.6%), 12 had pituitary adenoma (22.2%), 5 had meningocele (9.3%), 4 had traumatic CSF rhinorrhea (8%), 2 had germinoma (4%), 2 had malign tumors (4%), 2 had hypophysitis (4%), 2 had pilocytic astrocytoma (4%), 1 had basilar invagination (2%), 1 had fibrous dysplasia (2%), 1 had hemangiopericytoma (2%), 1 had neurocytoma (2%), 1 had dermoid cyst (2%), 1 had chordoma (2%), 1 had hamartoma (2%), 1 had abscess (2%), and 1 had capillary hemangioma (2%). Gross total resection was achieved in 33 (76.7%) of 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.

Conclusion: Endonasal endoscopic approach is an effective method for surgery in managing various pathologies of the pediatric age group. Due to its less invasive nature, it protects the developing bony structures of the face and the skull, while achieving satisfactory outcomes. Nevertheless, narrow transnasal corridor as well as inadequate sphenoid sinus pneumatization could be the main handicaps of this approach in pediatric patients.

No conflict of interest has been declared by the author(s).