Pediatric pituitary resection: characterizing surgical approaches and complications

Hanba, Curtis; Svider, Peter F.; Shkoukani, Mahdi A.; Sheyn, Anthony; Jacob, Jeffrey T.; Eloy, Jean Anderson; Folbe, Adam J.

doi:10.1002/alr.21840

Cited by 11 publications

(15 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study, utilizing the 2009 and 2012 databases, represents a comprehensive analysis with one coding scheme (ICD‐9). Several recent publications have used the KID in a similar manner to characterize other pediatric conditions …”

Section: Methodsmentioning

confidence: 99%

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Bou-Maroun

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Bou-Maroun

Meta

Hanba

et al. 2017

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…10 Not only were these complication rates lower than their transfrontal counterparts but transsphenoidal patients also had a shorter LOS and total cost. 10 With the support of these data, it is not surprising that pediatric skull base centers have followed suit with widespread adoption of TSPR; however, data on image guidance are still lacking in this population. This is the first study that demonstrates the increasing utilization of image guidance in pediatric TSPR cases.…”

Section: Discussionmentioning

confidence: 97%

“…This is a consequence of the infrequency of pediatric pituitary lesions, low necessity for surgery, and that the traditional transcranial approach is still more frequently performed than in adults. 10,12 Pediatric TSPR data are mostly limited to two larger case series and one population-based analysis. Jane et al studied 22 pediatric craniopharyngioma patients who underwent transsphenoidal resection.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Hanba et al investigated the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) and demonstrated a lower rate of complications, shorter hospital stay, and lower cost for transsphenoidal compared with transfrontal pituitary resection. 10 However, given the paucity of pediatric TSPR literature, there have been no studies investigating the use of image guidance in this population, to the best of our knowledge. Since this technology has become standard of care at many pediatric skull base centers, it is important to understand the ramifications of its use for the practicing clinician.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016

Lovin

Choi

et al. 2020

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Background To evaluate the utilization of image guidance technology for pediatric transsphenoidal pituitary resection (TSPR) and analyze the complication rates, length of stay (LOS), and total cost for such surgeries as function of time and utilization of image guidance. Methods The Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) was queried for all cases of TSPR between 1997 and 2016. Factors extracted included patient demographics, use of image guidance, LOS, total cost, and complications, including panhypopituitarism, diabetes insipidus (DI), cerebrospinal fluid (CSF) rhinorrhea, and cranial nerve (CN) III, IV, and VI palsies. Multivariate logistic regression was utilized to determine the odds ratio of developing panhypopituitarism, DI, CSF rhinorrhea, and CN palsies for image-guided versus nonimage-guided cases. A generalized linear model was used to determine the effect of image guidance on inflation-adjusted total cost and LOS. Results A total of 1,297 cases of TSPR were included in the KID over this time period. The majority were female, Caucasian, and older than 15 years. Utilization of image guidance has rapidly increased since 2006. Complication rates were comparable, but when controlling for other factors, the use of image guidance showed a lower risk of postoperative DI (p = 0.05). The use of image guidance also resulted in a shorter LOS by 2.84 days (p < 0.001) with no associated increase in total cost (p = 0.663). Conclusion The use of imaging guidance for pediatric TSPR has precipitously increased in recent years, as it is cost-effective, decreases LOS, and may lead to lower complication rates, such as DI.

show abstract

“…Visual changes (6.4%), CSF leak (2.3%), and intracranial bleeding (2.1%) are also uncommonly seen complications in pediatric adenoma management . Hanba et al revealed higher complication rates in patients under 10 years of age, with increased incidence of DI, hydrocephalus, and panhypopituitarism in younger patients . The most typical surgical indication for adenomas in children is symptoms related to hormonal secretion as opposed to macroadenomas with optic nerve compression as seen in adults .…”

Section: Discussionmentioning

confidence: 99%

The expanded endonasal approach in pediatric skull base surgery: A review

London

Rangel

Walz

2020

Laryngoscope Investig Oto

View full text Add to dashboard Cite

Objective: Surgery of the pediatric skull base has multiple unique challenges and has seen recent rapid advances. The objective of this review is to assess key issues in pediatric skull base surgery (SBS), including anatomic limitations, surgical approaches, reconstruction techniques, postoperative care, complications, and outcomes.Data Sources: PubMed literature review.Review Methods: A review of the literature was conducted to assess the challenges, recent advances, and reported outcomes in pediatric SBS.Results: The pediatric skull base presents multiple anatomic challenges, including variable patterns of pneumatization, narrow piriform aperture width, and narrow intercarotid distance at the level of the cavernous sinus but not the superior clivus. These issues may be particularly challenging in patients less than 2 years of age. Endoscopic endonasal approaches in the sagittal and coronal plane have been applied to the pediatric skull base while open approaches may still be necessary in the setting of extensive intracranial or orbital disease, as well as disease lateral to critical neurovascular structures. While the nasoseptal flap was initially called into question for pediatric cases, it has been shown through multiple reports to be a feasible and robust reconstructive option. Complications and outcomes often depend upon the pathology. In children, response to noxious stimuli, ability to avoid Valsalva, and adherence to nasal precautions is variable. The use of lumbar drains is more common in pediatric than adult patients.Conclusion: While the pediatric skull base presents unique challenges, outcomes data support that endoscopic endonasal approaches are a pertinent surgical technique in appropriately selected patients. Level of Evidence: 3aK E Y W O R D S endoscopic endonasal approach, pediatric skull base surgery, skull base reconstruction, surgical outcomes

show abstract

Pediatric pituitary resection: characterizing surgical approaches and complications

Cited by 11 publications

References 28 publications

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016

The expanded endonasal approach in pediatric skull base surgery: A review

Contact Info

Product

Resources

About