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Endoscopic endonasal skull base surgery for pediatric brain tumors

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Abstract

Purpose

The utility of endoscopic endonasal skull base surgery (EES) in various pathologic entities in adults has been published in the literature. However, the role of EES in children has not been clearly elucidated. We evaluated the feasibility of EES in children with brain tumors.

Methods

We retrospectively reviewed clinical features, surgical outcomes, and complications in children who underwent EES for intracranial and skull base tumors at a single institution from July 2010 to October 2018.

Results

A total of 82 patients underwent EESs for 77 intracranial and 5 skull base bony tumors. The mean age at diagnosis was 11.4 years (range 4–18 years), and the mean follow-up period was 46.8 months. The most common tumors were craniopharyngioma in the intracranial tumor and chordoma in the skull base. Gross total resection was the goal of surgery in 55 patients and achieved in 90.9%. The vision was improved in 76.1% of patients with visual impairments. Preoperatively, various endocrinological deficiencies were revealed in 73.7% of 76 patients with hypothalamus-pituitary lesions, and the hyposomatotropism was most common. Endocrinological status was improved only in 10. Aseptic or bacterial meningitis (7.3%) was the most common surgical complication, and the cerebrospinal fluid leakage rate was 2.4%.

Conclusions

EES provides favorable neurological outcomes with acceptable risk for children with brain tumors. The high incidence of endocrinological deficits in cases with hypothalamus-pituitary lesions emphasizes the importance of judicious pre- and postoperative evaluation.

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Funding

This study is supported by the by a grant (No. HI16C-1111-020016 to Kim YH) from the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea and a grant (No. NRF-2017R1A2B2008412 to Kim YH) from National Research Foundation of Korea by the Ministry of Science, ICT and Future Planning (MSIP) of Korea.

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Authors and Affiliations

  1. Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea

    Yong Hwy Kim, Ji Yeoun Lee, Ji Hoon Phi, Kyu-Chang Wang & Seung-Ki Kim

  2. Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children’s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea

    Ji Yeoun Lee, Ji Hoon Phi, Kyu-Chang Wang & Seung-Ki Kim

  3. Department of Anatomy, College of Medicine, Seoul National University, Seoul, Republic of Korea

    Ji Yeoun Lee

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  1. Yong Hwy Kim
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Corresponding author

Correspondence to Seung-Ki Kim.

Ethics declarations

This study was approved by the institutional review board of the author’s institution (No. 1903-086-1017) and included patients who underwent EES for intracranial or skull base bony tumors from July 2010 to October 2018.

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All authors have no conflict of interest to declare.

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Kim, Y.H., Lee, J.Y., Phi, J.H. et al. Endoscopic endonasal skull base surgery for pediatric brain tumors. Childs Nerv Syst 35, 2081–2090 (2019). https://doi.org/10.1007/s00381-019-04335-5

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