Download PDF
J Neurol Surg A Cent Eur Neurosurg 2014; 75(02): 133-139
DOI: 10.1055/s-0032-1327442
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Is There a Place for the Endoscope in Skull Base Surgery in Children Less Than 5 Years?

David Holzmann
1   Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
,
Oliver Bozinov
2   Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
,
Niklaus Krayenbühl
2   Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

17 February 2012

16 July 2012

Publication Date:
05 October 2012 (online)

    Permissions and Reprints

Abstract

Background The impact of transnasal endoscopic approaches to the central skull is still increasing. Its use in small children (i.e., under the age of 5 years) is of questionable value.

Patients and Methods The present study is a description of a series of five children under the age of 5 years with lesions of the central skull base.

Results Three out of five required a combined external and transnasal endoscopic approach. The transnasal access to the central skull base allowed reducing tissue damage and potentially may reduce growth deceleration.

Discussion Based on our experience on this small series we suggest that a transnasal endoscopic approach to the anterior and central skull base can be applied even in small children. To successfully operate on such delicate pathologies, a well-working interdisciplinary cooperation is mandatory.

Keywords

endoscopy - pediatric - skull base surgery
 

  • References

  • 1 Cavallo LM, Cappabianca P, Galzio R, Iaconetta G, de Divitiis E, Tschabitscher M. Endoscopic transnasal approach to the cavernous sinus versus transcranial route: anatomic study. Neurosurgery 2005; 56 (2, Suppl): 379-389 , discussion 379–389
    CrossrefPubMedGoogle Scholar
  • 2 Frank G, Sciarretta V, Calbucci F, Farneti G, Mazzatenta D, Pasquini E. The endoscopic transnasal transsphenoidal approach for the treatment of cranial base chordomas and chondrosarcomas. Neurosurgery 2006; 59 (1) (Suppl. 01) ONS50-ONS57 , discussion ONS50–ONS57
    PubMedGoogle Scholar
  • 3 Cappabianca P, Kelly DF, Laws Jr ER. Endoscopic transnasal versus open transcranial cranial base surgery: the need for a serene assessment. Neurosurgery 2008; 63 (4) (Suppl. 02) 240-241 , discussion 241–243
    CrossrefPubMedGoogle Scholar
  • 4 Kassam A, Thomas AJ, Snyderman C , et al. Fully endoscopic expanded endonasal approach treating skull base lesions in pediatric patients. J Neurosurg 2007; 106 (2, Suppl): 75-86
    PubMedGoogle Scholar
  • 5 Gil Z, Patel SG, Cantu G , et al; International Collaborative Study Group. Outcome of craniofacial surgery in children and adolescents with malignant tumors involving the skull base: an international collaborative study. Head Neck 2009; 31: 308-317
    CrossrefPubMedGoogle Scholar
  • 6 Fishman G, Fliss DM, Benjamin S , et al. Multidisciplinary surgical approach for cerebrospinal fluid leak in children with complex head trauma. Childs Nerv Syst 2009; 25: 915-923
    CrossrefPubMedGoogle Scholar
  • 7 Yoon SH, Park S-H. A study of 77 cases of surgically excised scalp and skull masses in pediatric patients. Childs Nerv Syst 2008; 24: 459-465
    CrossrefPubMedGoogle Scholar
  • 8 Di Rocco F, Couloigner V, Dastoli P, Sainte-Rose C, Zerah M, Roger G. Treatment of anterior skull base defects by a transnasal endoscopic approach in children. J Neurosurg Pediatr 2010; 6: 459-463
    CrossrefPubMedGoogle Scholar
  • 9 Shah RN, Surowitz JB, Patel MR , et al. Endoscopic pedicled nasoseptal flap reconstruction for pediatric skull base defects. Laryngoscope 2009; 119: 1067-1075
    CrossrefPubMedGoogle Scholar
  • 10 Abdel-Aziz M, El-Bosraty H, Qotb M , et al. Nasal encephalocele: endoscopic excision with anesthetic consideration. Int J Pediatr Otorhinolaryngol 2010; 74: 869-873
    CrossrefPubMedGoogle Scholar
  • 11 Marton E, Billeci D, Schiesari E, Longatti P. Transnasal endoscopic repair of cerebrospinal fluid fistulas and encephaloceles: surgical indications and complications. Minim Invasive Neurosurg 2005; 48: 175-181
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Soyka MB, Holzmann D. Correlation of complications during endoscopic sinus surgery with surgeon skill level and extent of surgery. Am J Rhinol 2005; 19: 274-281
    PubMedGoogle Scholar
  • 13 Holzmann D, Reisch R, Krayenbühl N, Hug E, Bernays RL. The transnasal transclival approach for clivus chordoma. Minim Invasive Neurosurg 2010; 53: 211-217
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Locatelli D, Rampa F, Acchiardi I, Bignami M, Pistochini A, Castelnuovo P. Endoscopic endonasal approaches to anterior skull base defects in pediatric patients. Childs Nerv Syst 2006; 22: 1411-1418
    CrossrefPubMedGoogle Scholar
  • 15 Van Den Abbeele T, Elmaleh M, Herman P, François M, Narcy P. Transnasal endoscopic repair of congenital defects of the skull base in children. Arch Otolaryngol Head Neck Surg 1999; 125: 580-584
    CrossrefPubMedGoogle Scholar
  • 16 Gil Z, Patel SG, Cantu G , et al; International Collaborative Study Group. Outcome of craniofacial surgery in children and adolescents with malignant tumors involving the skull base: an international collaborative study. Head Neck 2009; 31: 308-317
    CrossrefPubMedGoogle Scholar
  • 17 Anderson S, Panizza B. Are cell salvage and autologous blood transfusion safe in endonasal surgery?. Otolaryngol Head Neck Surg 2010; 142 (3) (Suppl. 01) S3-S6
    CrossrefPubMedGoogle Scholar
  • 18 Suzuki M, Sakurai H, Seno S , et al. [Endoscopic resection of benign and malignant tumors in the nasal cavity and paranasal sinus]. Nippon Jibiinkoka Gakkai Kaiho 2005; 108: 724-733
    CrossrefPubMedGoogle Scholar
  • 19 Desmond M, Gillon J, Thomas MJG. Perioperative red cell salvage: a case for implementing the 1995 consensus statement. Transfus Med 1999; 9: 265-268
    CrossrefPubMedGoogle Scholar
  • 20 Castelnuovo P, Dallan I, Bignami M, Pistochini A, Battaglia P, Tschabitscher M. Endoscopic endonasal management of petroclival cerebrospinal fluid leaks: anatomical study and preliminary clinical experience. Minim Invasive Neurosurg 2008; 51: 336-339
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Calstelnuovo P, Bignami M, Pistochini A, Battaglia P, Locatelli D, Dallan I. Endoscopic endonasal management of encephaloceles in children: An eight-year experience. Int J Pediatr Otorhinolaryngol 2009; 73: 1132-1136
    CrossrefPubMedGoogle Scholar
  • 22 Martin TJ, Loehrl TA. Endoscopic CSF leak repair. Curr Opin Otolaryngol Head Neck Surg 2007; 15: 35-39
    CrossrefPubMedGoogle Scholar
  • 23 Sciarretta V, Mazzatenta D, Ciarpaglini R, Pasquini E, Farneti G, Frank G. Surgical repair of persisting CSF leaks following standard or extended endoscopic transsphenoidal surgery for pituitary tumor. Minim Invasive Neurosurg 2010; 53: 55-59
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Shah RN, Surowitz JB, Patel MR , et al. Endoscopic pedicled nasoseptal flap reconstruction for pediatric skull base defects. Laryngoscope 2009; 119: 1067-1075
    CrossrefPubMedGoogle Scholar
  • 25 Verwoerd CD, Verwoerd-Verhoef HL. Rhinosurgery in children: basic concepts. Facial Plast Surg 2007; 23: 219-230
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Pinheiro-Neto CD, Carrau RL, Prevedello DM , et al. Use of acoustic Doppler sonography to ascertain the feasibility of the pedicled nasoseptal flap after prior bilateral sphenoidotomy. Laryngoscope 2010; 120: 1798-1801
    CrossrefPubMedGoogle Scholar
  • 27 Harvey RJ, Parmar P, Sacks R, Zanation AM. Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence. Laryngoscope 2012; 122: 452-459
    CrossrefPubMedGoogle Scholar
  • 28 Solyar AY, Fried MP, Goldberg AN, Kennedy DW, Lanza DC. Pedicled nasoseptal flap is not the standard of care for skull base defects. Laryngoscope 2011; 121: 896-897 , author reply 898
    CrossrefPubMedGoogle Scholar