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Child's Nervous System
Published in: Child's Nervous System 11/2019

01-11-2019 | Pituitary Adenoma | Focus Session

Outcomes following endoscopic endonasal resection of sellar and supresellar lesions in pediatric patients

Authors: Christoforos Koumas, Anya Laibangyang, Shanna L. Barron, Mark A. Mittler, Steven J. Schneider, Shaun D. Rodgers

Published in: Child's Nervous System | Issue 11/2019

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Abstract

Purpose

The endoscopic endonasal approach (EEA) is a credible surgical alternative for the resection of sellar and suprasellar lesions such as pituitary adenomas, craniopharyngiomas, and Rathke cleft cysts. However, its application to pediatric patients poses several unique challenges that have not yet been well evaluated. The authors evaluate the safety, efficacy, and outcomes associated with the use of the EEA for treatment of these pathologic entities in pediatric patients.

Methods

Retrospective review of 30 patients between the ages of two and 24 who underwent endoscopic endonasal resection of sellar or suprasellar lesions between January 2010 and December 2015. Endocrinological and ophthalmological outcomes, as well as extent of resection and complications were all evaluated.

Results

Gross total resection was achieved in eight of the nine pituitary adenomas, nine of the 12 craniopharyngiomas, and six of the nine Rathke cleft cysts. Of the 30 patients, 22 remained disease free at last follow-up. A total of six patients developed hypopituitarism and five developed diabetes insipidus. Eleven patients experienced improved vision, sixteen experienced no change, and one patient experienced visual worsening. Postoperative cerebrospinal fluid leak was seen in a single case and later resolved, vasospasm/stroke was experienced by 10% of patients, and new obesity was recorded in 10% of patients. There were no perioperative deaths.

Conclusions

Endoscopic endonasal resection is a safe and effective surgical alternative for the management of sellar and suprasellar pathologies in pediatric populations with excellent outcomes, minimal complications, and a low risk of morbidity.
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Metadata
Title
Outcomes following endoscopic endonasal resection of sellar and supresellar lesions in pediatric patients
Authors
Christoforos Koumas
Anya Laibangyang
Shanna L. Barron
Mark A. Mittler
Steven J. Schneider
Shaun D. Rodgers
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 11/2019
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-019-04258-1

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