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The impact of expanded endonasal skull base surgery on midfacial growth in pediatric patients.

Authors :
Parasher AK
Lerner DK
Glicksman JT
Storm PB
Lee JYK
Vossough A
Brooks S
Palmer JN
Adappa ND
Source :
The Laryngoscope [Laryngoscope] 2020 Feb; Vol. 130 (2), pp. 338-342. Date of Electronic Publication: 2019 May 09.
Publication Year :
2020

Abstract

Objective: Surgical resection of skull base tumors in children is increasingly accomplished through an expanded endonasal approach (EEA). We aim to evaluate the potential effect of the EEA on midfacial growth as a result of iatrogenic damage to nasal growth zones.<br />Methods: We performed a retrospective review of children undergoing craniopharyngioma resection via an open transcranial or EEA. Pre- and postoperative magnetic resonance imaging was evaluated for growth in four midfacial measurements based on established cephalometric landmarks: anterior midface height, posterior midface height, palatal length, and sella-nasion distance. Statistical analysis was conducted using a mixed-effects linear regression model.<br />Results: Twenty-two patients underwent an EEA (n = 12) or open transcranial approach (n = 10) for tumor resection with 3 years of imaging follow-up. There was no difference in midfacial growth between groups for each measurement. Compared to the open group, patients undergoing EEA demonstrated relative anterior midface height growth of -0.42 mm (P = 0.880), posterior midface height growth of -0.44 mm (P = 0.839), palatal length growth of 0.35 mm (P = 0.894), and sella-nasion distance growth of -2.16 (P = 0.365).<br />Conclusion: We found no difference in midfacial growth measurements between patients undergoing craniopharyngioma resection via an EEA and the open transcranial route after 3 years of imaging follow-up. Preliminary results on midfacial growth demonstrate that the EEA is a safe alternative to traditional transcranial approaches for the pediatric population. Further investigation with larger sample size and longer duration of follow-up is warranted to more thoroughly investigate the long-term implications of the EEA to the skull base.<br />Level of Evidence: 3 Laryngoscope, 130:338-342, 2020.<br /> (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)

Details

Language :
English
ISSN :
1531-4995
Volume :
130
Issue :
2
Database :
MEDLINE
Journal :
The Laryngoscope
Publication Type :
Academic Journal
Accession number :
31070247
Full Text :
https://doi.org/10.1002/lary.28063