Surgery of Anterior Skull Base Lesions in Children

Hoffmann, Thomas; Scheithauer, Marc O.; Sommer, Fabian; Lindemann, Jörg; Haberl, Ernst-Johannes; Friebe-Hoffmann, U; Theodoraki, Marie‐Nicole

doi:10.1177/0003489416685321

Cited by 8 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a case series of 13 children with anterior skull base congenital lesions who underwent transnasal, transcutaneous, and/or transcranial surgical intervention, no postoperative morbidity or mortality was reported. 22 Other studies estimated an incidence of 2.9% for minor postoperative complications, while major complications occurred at a rate of 0.08% to 0.55%. 2,6,17 In a retrospective review of nationwide data for inpatient and outpatient sinus surgery, Ramakrishnan et al 17 reported complication rates by age.…”

Section: Discussionmentioning

confidence: 97%

Perioperative Risk Factors Associated With Morbidity and Mortality Following Pediatric Inpatient Sinus Surgery

Burton

Gilani

Desai

et al. 2018

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objectives: Pediatric sinus surgery is indicated for a wide range of sinonasal and skull base pathologies, but it is most commonly performed for recalcitrant chronic rhinosinusitis or complicated acute sinusitis. The authors aim to report medical risk factors of morbidity and mortality following inpatient sinus surgery in the pediatric population. Methods: Using data from the Kids' Inpatient Database from 2003 to 2012, patients with International Classification of Diseases, Ninth Revision, procedure codes for primary sinus surgery were identified. Mixed-effect multivariable logistic regression was used to identify risk factors of inpatient postoperative morbidity and mortality. Results: The final sample included a weighted estimate of 4965 pediatric patients. The rates of inpatient morbidity and mortality were 6% and 1%, respectively. Respiratory complications (2.5%) were the most prevalent postoperative adverse events. The most prevalent comorbidities were chronic sinusitis (59.8%), acute sinusitis (27.8%), and cystic fibrosis (26.4%). Compared with patients who did not experience any morbidity, patients with inpatient morbidity had higher rates of pneumonia, mycoses, and nasal or paranasal benign neoplasm (P < .05). The odds of inpatient morbidity and mortality were highest for patients with leukemia (odds ratio, 2.74; 95% confidence interval, 1.59-4.72; P < .001) and mycoses (odds ratio, 15.84; 95% confidence interval, 6.45-38.89; P < .001), respectively. Conclusions: This study is the first to report the national comorbidity burden and risk factors for postoperative adverse events following inpatient sinus surgery. Knowledge of the comorbidities and independent factors associated with morbidity and mortality will help in directing preoperative optimization and counseling.

show abstract

Section: Discussionmentioning

confidence: 97%

Perioperative Risk Factors Associated With Morbidity and Mortality Following Pediatric Inpatient Sinus Surgery

Burton

Gilani

Desai

et al. 2018

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

show abstract

“…The differential diagnoses in our patient included nasal glioma, encephalocele, congenital hemangioma, sebaceous cyst, and lipoma [ 5 , 8 ]. A nasal glioma is an ectopic, neuroectoderm from early development that presents as a firm, noncompressible, flesh-colored nodule.…”

Section: Discussionmentioning

confidence: 99%

Nasal Dermoid Cyst: A Case Report

Hawsawi¹,

Alosaimi²,

Aljohani³

et al. 2022

Cureus

View full text Add to dashboard Cite

A dermoid cyst (DC) is a rare, benign congenital skin lesion that can occur anywhere on the skin and take any shape. DC is clinically diagnosed through imaging and biopsy. The usual treatment of choice for DC is surgical excision to prevent any local complications, such as inflammation, infection, and bone resorption. The type of surgery depends on the size, location, and extension of the cyst. When the cyst presents in certain areas, such as the nose, face, and scalp, surgery can be difficult owing to the possibility of an intracranial connection. Therefore, imaging is usually performed before intervening surgically. Here, we present the case of a two-year-old boy with no medical or surgical history who presented to our dermatology clinic with a slow-growing mass on his nose. During the consultation, the mass was examined, a complete medical history was obtained, and the patient was advised to undergo imaging, which revealed that the mass was a DC. Nevertheless, no deep connection was observed on imaging, and the mass was surgically removed without any complications.

show abstract

“…The pediatric population presents challenges from small surgical corridors to non-pneumatized sinuses [25]. The approach has been expanded to include younger patients and additional pathology including Rathke cleft cysts, pituitary adenomas, arachnoid cysts, craniopharyngioma, and other less common lesions [34][35][36][37]. The effect of pediatric EES on long-term midface growth is still unclear.…”

Section: Discussionmentioning

confidence: 99%

Influence of Pediatric Endoscopic Endonasal Skull Base Resections on Midface and Skull Base Development

et al. 2021

View full text Add to dashboard Cite

Objective: The purpose of this study is to use imaging data to determine if endoscopic endonasal surgery (EES) for skull base tumor resection interrupts skull base growth and development, resulting in an atrophic midface skeletal structure, compared to matched normal controls. Methods: Data were collected by a retrospective chart review done on children aged 16 years and below who underwent endoscopic tumor resection and had pre- and postoperative magnetic resonance imaging with relevant midface anatomy. 121 normal controls were matched to 20 EES patients by age and gender. Three measurements related to midface anatomy were taken from 1 sagittal T1 slice and 1 axial T2 slice of each scan. Statistical analysis was used to compare growth measures between cases and controls. Results: Twenty patients who underwent EES between November 2015 and April 2018 met our inclusion criteria. The mean age of the patients, 11 males and 9 females, was 10 years, and 8 patients (38%) were aged 7 years or younger. Six patients who had a high-flow CSF leak obtained a nasoseptal flap. A student T test and multivariate regression analysis found that EES did not affect midface and skull base growth. Among the variables assessed, age appears to be the only driver of growth. Conclusion: There were no identified differences in craniofacial growth in pediatric patients undergoing EES for skull base tumor resection as compared to the control group. EES does not appear to significantly interfere with midface/skull base development and is a good surgical option for pediatric patients.

show abstract

Surgery of Anterior Skull Base Lesions in Children

Abstract: Congenital pathologies of the anterior skull base are rare, challenging to diagnose, and present as clinical emergencies. An interdisciplinary surgical approach is needed for best functional and aesthetic results.

Cited by 8 publications

References 25 publications

Perioperative Risk Factors Associated With Morbidity and Mortality Following Pediatric Inpatient Sinus Surgery

Perioperative Risk Factors Associated With Morbidity and Mortality Following Pediatric Inpatient Sinus Surgery

Nasal Dermoid Cyst: A Case Report

Influence of Pediatric Endoscopic Endonasal Skull Base Resections on Midface and Skull Base Development

Contact Info

Product

Resources

About