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Objectives: To review developmental surgical anatomy and technical nuances related to pediatric skull base surgery. Design: Retrospective, single-center case series with literature review. Setting: MD Anderson Cancer Center. Participants: Patients undergoing pediatric skull base surgery. Main Outcome Measures: Review developmental anatomy of the pediatric skull base as it relates to technical nuance of various surgical approaches and insight gained from a 25-year institutional experience with this unique patient population. Results: Thirty-nine patients meeting these criteria were identified over a 13-year period from 2003 to 2016 and compared to a previously reported earlier cohort from 1992 to 2002. The most common benign pathologies included nerve sheath tumors (11%), juvenile nasopharyngeal angiofibromas (9.5%), and craniopharyngiomas (4.8%). Themost common malignancies were chondrosarcoma (11%), chordoma (11%), and rabdomyosarcoma (11%). Varied surgical approaches were utilized and were similar between the two cohorts save for the increased use of endoscopic surgical techniques in themost recent cohort. The most common sites of tumor origin were the infratemporal fossa, sinonasal cavities, clivus, temporal bone, and parasellar region. Gross total resection and postoperative complication rates were similar between the two patient cohorts. Conclusions: Pediatric skull base tumors, while rare, often are treated surgically, necessitating an in depth understanding of the anatomy of the developing skull base. [ABSTRACT FROM AUTHOR]

Purpose: We present a small series consisting of eight children with unilateral facet injury of the cervical spine treated surgically. Methods: A retrospective review was performed. Injury data, radiographs, surgical data, and outcomes (Neck Disability Index (NDI), Short Form 36 (SF-36), and Visual Analog Scale for Neck Pain (VAS-NP)) were collected from seven patients. A literature review was performed for one additional case. Results: Motor vehicle accidents (62 %, n = 5) and falls (38 %, n = 3) accounted for all injuries. The C6-7 level accounted for most of the injuries (37.5 %, n = 3). The mean NDI score with at least 3 months follow-up was 5.3 ( n = 6, range, 1-12; standard deviation, 4.5), corresponding to mild disability. Of the norm-based SF-36 scale scores available ( n = 6), the mean physical functioning (PF), role-physical (RP), and role-emotional (RE) scores were significantly less than the adult, age 18-24, norm-based means, with a mean difference of −6.4, −9.13, and −11.3, respectively ( p value = 0.03, 0.001, and 0.01, respectively). The mean general health (GH) and vitality (VT) scores, however, were significantly greater than the adult, age 18-24, norm-based mean, with a mean difference of 7.82 and 10.3 ( p = 0.04 and 0.02, respectively). VAS-NP showed a return to the 'no pain' level at 3 months or more follow-up in all patients. Conclusions: We suggest that surgical treatment of these injuries in the pediatric age group may lead to satisfactory clinical and radiographic outcomes, but HRQoL analysis suggests that patients remain physically and emotionally disabled to some degree after surgery. [ABSTRACT FROM AUTHOR]