Endonasal endoscopic approach for intracranial nasal dermoid sinus cysts in children

Moon, Re; Tarchini, Paolo; Macrı̀, Giovanni; Pasquini, Ernesto

doi:10.1016/j.ijporl.2012.05.004

Cited by 40 publications

(30 citation statements)

References 39 publications

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“…Two of these patients underwent vertical excision and two medial paracanthal (Lynch) incisions. None had evidence of a sinus tract or intracranial extension, and none had recurrence at a mean follow-up of 8.5 years (range, [5][6][7][8][9][10][11][12].…”

Section: Resultsmentioning

confidence: 99%

“…However, in recent years both subcranial and endoscopic approaches have been proposed. These avoid the morbidity of frontal craniotomy, which may include meningitis, hyposmia, CSF leak, damage to the frontal and sagittal sinuses, intracerebral hemorrhage, cerebral edema, epilepsy, memory and concentration deficits, and osteomyelitis of the frontal bone …”

Section: Discussionmentioning

confidence: 99%

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Update on current evaluation and management of pediatric nasal dermoid

et al. 2016

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Update on current evaluation and management of pediatric nasal dermoid

et al. 2016

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“…A rate of 22% among patients with dermoid and epidermoid tumors may appear high; however, microscopic ectodermal derivatives that may be left behind in their resection are notorious for causing postoperative recurrence or infection. 57 An issue that has been variously considered by authors reporting on complications of endonasal skull base surgery in the adult population is that cranial base reconstruction through the nose may increase the risk of postoperative CSF leaks, and consequently, the risk of postoperative infection, especially of bacterial meningitis. 26,35 While it is true that endonasal skull base reconstruction is not trivial, our recent experience with the use of the vascularized nasoseptal flap and the resulting significantly decreased rates of CSF leaks has led us to believe that this reconstructive technique may provide a solution to the current problem.…”

Section: Infectious Complicationsmentioning

confidence: 99%

Endoscopic endonasal skull base surgery in the pediatric population

Chivukula

Koutourousiou²,

Snyderman

et al. 2013

PED

139

136

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Object The use of endoscopic endonasal surgery (EES) for skull base pathologies in the pediatric population presents unique challenges and has not been well described. The authors reviewed their experience with endoscopic endonasal approaches in pediatric skull base surgery to assess surgical outcomes and complications in the context of presenting patient demographics and pathologies. Methods A retrospective review of 133 pediatric patients who underwent EES at our institution from July 1999 to May 2011 was performed. Results A total of 171 EESs were performed for skull base tumors in 112 patients and bony lesions in 21. Eighty-five patients (63.9%) were male, and the mean age at the time of surgery was 12.7 years (range 2.3–18.0 years). Skull base tumors included angiofibromas (n = 24), craniopharyngiomas (n = 16), Rathke cleft cysts (n = 12), pituitary adenomas (n = 11), chordomas/chondrosarcomas (n = 10), dermoid/epidermoid tumors (n = 9), and 30 other pathologies. In total, 19 tumors were malignant (17.0%). Among patients with follow-up data, gross-total resection was achieved in 16 cases of angiofibromas (76.2%), 9 of craniopharyngiomas (56.2%), 8 of Rathke cleft cysts (72.7%), 7 of pituitary adenomas (70%), 5 of chordomas/chondrosarcomas (50%), 6 of dermoid/epidermoid tumors (85.7%), and 9 cases of other pathologies (31%). Fourteen patients received adjuvant radiotherapy, and 5 received chemotherapy. Sixteen patients (15.4%) showed tumor recurrence and underwent reoperation. Bony abnormalities included skull base defects (n = 12), basilar invagination (n = 4), optic nerve compression (n = 3) and trauma (n = 2); preexisting neurological dysfunction resolved in 12 patients (57.1%), improved in 7 (33.3%), and remained unchanged in 2 (9.5%). Overall, complications included CSF leak in 14 cases (10.5%), meningitis in 5 (3.8%), transient diabetes insipidus in 8 patients (6.0%), and permanent diabetes insipidus in 12 (9.0%). Five patients (3.8%) had transient and 3 (2.3%) had permanent cranial nerve palsies. The mean follow-up time was 22.7 months (range 1–122 months); 5 patients were lost to follow-up. Conclusions Endoscopic endonasal surgery has proved to be a safe and feasible approach for the management of a variety of pediatric skull base pathologies. When appropriately indicated, EES may achieve optimal outcomes in the pediatric population.

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“…Nevertheless, many pathologic lesions, such as intraorbital abscesses, hematomas, and tumors located in the medial intraorbital area and the orbital apex can be approached by extended pure endoscopic endonasal techniques, with minimal globe retraction, and medial orbital reconstruction is possible, and recently, endoscopic endonasal approaches have been used to treat some pediatric neoplasms …”

Section: Discussionmentioning

confidence: 99%