Abstract
Introduction In pediatric patients, endoscopic transnasal surgery (ETNS) poses challenges because
of the small size of the developing skull and narrow endonasal corridors.
Objective This study aimed to evaluate the efficacy of ETNS in children by assessing our experience
of endoscopic skull base surgery.
Materials and Methods All pediatric patients (n = 54) who were eligible for surgery using only the endonasal endoscopic approach
at our tertiary center between 2012 and 2018 were included in this study. The surgeries
were performed simultaneously by an endoscopic skull base team of neurosurgeons and
otolaryngologists. Hormonal analyses were conducted before and after surgery in all
patients with sellar/parasellar lesions. Patients older than 8 years underwent smell
and visual testing.
Results In the 54 patients aged 1 to 17 years who underwent surgery, craniopharyngioma was
the most common pathology (29.6%), followed by pituitary adenoma (22.2%). Gross total
resection was achieved in 33 (76.7%) of 41 patients who underwent surgery because
of the presence of tumors. All visual deficits improved, although one patient sustained
olfactory deterioration. Sixteen (29.6%) patients presented with complications such
as transient diabetes insipidus and temporary visual loss.
Conclusions Despite anatomy-related challenges in children, adequate results can be achieved
with high rates of success, and the functional and anatomical integrity of the developing
skull and nose of children can be preserved. In pediatric patients, ETNS is a safe
and effective option for addressing various lesions along the skull base.
Keywords
endoscopic - pediatric - skull base - surgery - endonasal - transsphenoidal