[Endoscopic Skull Base Surgery in the Pediatric Population: A Tertiary Center Experience in the Last Decade].

INTRODUCTION

The endoscopic endonasal surgical approach to skull-base ventral lesions (SBVL) poses unique challenges in the pediatric population, affecting the array of considerations between the transcranial and endonasal approaches.

AIMS: Our aim is to present our experience with the endoscopic endonasal approach in SBVL among the pediatric population.

METHODS

A retrospective cohort study was conducted. Data regarding demographics, medical comorbidities, symptoms and signs upon initial presentation, imaging findings, histopathology, surgical outcomes, post-operative course and complication was gathered.

RESULTS

A total of 50 children were operated on between 2014-2024 in the Tel-Aviv Sourasky Medical Center, 28 (56%) boys and 22 (44%) girls, averagely aging 12.35±5.09 years. Half of the tumors were benign, most commonly craniopharyngiomas (11 children, 22%). Half of the children suffered from intra-operative CSF leak; 30% of the children underwent revision surgery. Only 3 children (6%) had post-operation major complications, which were more common among the older children and those with ocular complaints upon initial presentation.

CONCLUSIONS

The endoscopic approach to SBVL in the pediatric population is feasible and safe, in a large variety of pathologies and age groups, with a reasonable complication rate. The pediatric population poses unique surgical challenges that may be overcome by a skilled multidisciplinary team.