Endoscopic Endonasal Transsphenoidal Approach for Sellar and Perisellar Lesions in Children: Interdisciplinary Experiences
Purpose: To evaluate the surgical results of endoscopic transsphenoidal approaches for sellar region tumors in children. Methods: From 2003 to 2008, 12 children with intra- and/or extrasellar lesions were treated by 15 endoscopic image-guided transsphenoidal approaches by a multidisciplinary team. T...
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Published in | Skull Base Vol. 19; no. 1 |
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Main Author | |
Format | Conference Proceeding Journal Article |
Language | English |
Published |
14.04.2009
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Online Access | Get full text |
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Summary: | Purpose:
To evaluate the surgical results of endoscopic transsphenoidal approaches for sellar region tumors in children.
Methods:
From 2003 to 2008, 12 children with intra- and/or extrasellar lesions were treated by 15 endoscopic image-guided transsphenoidal approaches by a multidisciplinary team. The mean age was 13.7 years (range, 4–18 years); 58.3% were female. Visual field deficiency was present in 4 children.
Results:
Mean follow-up was 20.5 months (range, 0–50 months); 1 patient was lost to follow-up. Histological diagnosis disclosed pituitary adenoma in 5 children; 2 had craniopharyngioma; and 5 patients had other pathologies such as Rathke cleft cyst, PNET, low-grade astrocytoma, schwannoma, and osteoma. Total removal was achieved in 6 cases, subtotal removal in 3, partial removal in 5, and biopsy was the aim of surgery in 2 children. Postoperative complications comprising cerebrospinal fluid rhinorrhea and transient diabetes insipidus (DI) occurred in 33.3%(
n
= 4); only 1 child showed permanent DI. Further treatment consisted of 3 endoscopic reoperations, 2 craniotomies, and 3 radiosurgical procedures due to residual or recurrent tumors. Visual field normalized in 3 children; in 1 it remained stable.
Conclusion:
The endoscopic transsphenoidal approach has shown to be applicable for a wide variety of intra- and extrasellar lesions. The procedure is minimally invasive compared with the inflicting alternative transcranial procedures and can be regarded as safe with very satisfying results even in children. |
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ISSN: | 1531-5010 1532-0065 |
DOI: | 10.1055/s-2009-1222205 |