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Lack of Sphenoid Pneumatization Does Not Affect Endoscopic Endonasal Pediatric Skull Base Surgery Outcomes.
- Source :
-
The Laryngoscope [Laryngoscope] 2019 Apr; Vol. 129 (4), pp. 832-836. Date of Electronic Publication: 2018 Dec 05. - Publication Year :
- 2019
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Abstract
- Objectives/hypothesis: Currently, due to the rarity of pathology, there are limited data surrounding outcomes of pediatric skull base surgery. Traditionally, surgeons have proceeded with caution when electing endonasal endoscopic transsellar/transplanum approaches to the skull base in pediatric patients due to poor sphenoid pneumatization. In this study, we review outcomes of endoscopic pediatric skull base surgery based on sphenoid pneumatization patterns.<br />Study Design: Retrospective chart review.<br />Methods: A review of all cases of pediatric (age < 18 years) craniopharyngioma managed via an endoscopic endonasal approach at a tertiary academic medical center.<br />Results: A total of 27 patients were included in the analysis. The median age was 8 years. Nineteen (70%) patients were male. Presellar, sellar/postsellar, and conchal sphenoid pneumatizations were found in 6, 11, and 10 patients, respectively. There was no significant association between sphenoid pneumatization pattern and extent of resection (gross vs. subtotal, P = .414), postoperative cerebrospinal fluid (CSF) leak (P = .450), intraoperative estimated blood loss (P = .098), total operative time (P = .540), and length of stay (P = .336). On multivariate analysis, after accounting for age, sex, preoperative cranial nerve involvement, and cavernous sinus invasion, there remained no significant association between sphenoid pneumatization pattern and extent of resection (P = .999) and postoperative CSF leak (P = .959).<br />Conclusions: Sphenoid pneumatization pattern does not appear to affect outcomes in endoscopic skull base surgery in the pediatric population. Importantly, lack of sphenoid pneumatization does not impede gross total resection or increase complications. Thorough knowledge of the anatomy during the endoscopic approach is critical to optimize outcomes.<br />Level of Evidence: 4 Laryngoscope, 129:832-836, 2019.<br /> (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)
- Subjects :
- Air
Child
Craniopharyngioma pathology
Endoscopy adverse effects
Female
Humans
Male
Nose surgery
Pituitary Neoplasms pathology
Postoperative Complications epidemiology
Postoperative Complications etiology
Retrospective Studies
Sphenoid Bone anatomy & histology
Treatment Outcome
Craniopharyngioma surgery
Endoscopy methods
Pituitary Neoplasms surgery
Skull Base surgery
Sphenoid Bone surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1531-4995
- Volume :
- 129
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 30520033
- Full Text :
- https://doi.org/10.1002/lary.27600