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

01-11-2019 | Pituitary Adenoma | Focus Session

Endoscopic endonasal skull base surgery for pediatric brain tumors

Authors: Yong Hwy Kim, Ji Yeoun Lee, Ji Hoon Phi, Kyu-Chang Wang, Seung-Ki Kim

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

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Abstract

Purpose

The utility of endoscopic endonasal skull base surgery (EES) in various pathologic entities in adults has been published in the literature. However, the role of EES in children has not been clearly elucidated. We evaluated the feasibility of EES in children with brain tumors.

Methods

We retrospectively reviewed clinical features, surgical outcomes, and complications in children who underwent EES for intracranial and skull base tumors at a single institution from July 2010 to October 2018.

Results

A total of 82 patients underwent EESs for 77 intracranial and 5 skull base bony tumors. The mean age at diagnosis was 11.4 years (range 4–18 years), and the mean follow-up period was 46.8 months. The most common tumors were craniopharyngioma in the intracranial tumor and chordoma in the skull base. Gross total resection was the goal of surgery in 55 patients and achieved in 90.9%. The vision was improved in 76.1% of patients with visual impairments. Preoperatively, various endocrinological deficiencies were revealed in 73.7% of 76 patients with hypothalamus-pituitary lesions, and the hyposomatotropism was most common. Endocrinological status was improved only in 10. Aseptic or bacterial meningitis (7.3%) was the most common surgical complication, and the cerebrospinal fluid leakage rate was 2.4%.

Conclusions

EES provides favorable neurological outcomes with acceptable risk for children with brain tumors. The high incidence of endocrinological deficits in cases with hypothalamus-pituitary lesions emphasizes the importance of judicious pre- and postoperative evaluation.
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Metadata
Title
Endoscopic endonasal skull base surgery for pediatric brain tumors
Authors
Yong Hwy Kim
Ji Yeoun Lee
Ji Hoon Phi
Kyu-Chang Wang
Seung-Ki Kim
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/s00381-019-04335-5

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