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CSF leak after pediatric endoscopic endonasal expanded approaches: a series review

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Abstract

Purpose

Endoscopic endonasal approaches in the pediatric population pose specific challenges. Management of postoperative cerebrospinal fluid [CSF] leak is probably the major concern. The purpose of the present investigation is to describe and analyze the incidence of postoperative CSF leaks in our pediatric series of endoscopic endonasal approaches.

Methods

This is a retrospective analysis, case review of our institutional series. Descriptive statistical parameters and bivariate correlations are analyzed.

Results

Twenty-one patients have been operated through endoscopic approaches in our series. Four patients showed a postoperative CSF leak needing a revision surgery; these cases are described in further detail. Approaches expanded beyond the sellar area and non-sellar pneumatization of the sphenoid sinus were significantly associated with a higher risk of postoperative CSF leak.

Conclusions

CSF leak incidence after endoscopic endonasal approaches is higher in pediatric patients than in adult series. Anatomic and pathologic factors add complexity to these approaches in children. Multilayer closure is advisable to prevent and treat this complication.

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Authors and Affiliations

  1. Pediatric Neurosurgery, Hospital Universitari I Politècnica La Fe, 46010, Valencia, Spain

    Pablo Miranda-Lloret, Juan Antonio Simal-Julian, Laila Pérez de San Román-Mena, Estela Plaza Ramírez, Giovanni Pancucci & Carlos Botella Asunción

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  1. Pablo Miranda-Lloret
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Contributions

Pablo Miranda, Juan Antonio Simal and Laila Pérez de San Roman wrote the main manuscript text. Pablo Miranda, Estela Plaza and Giovanni Pancucci prepared the tables and figures. All authors reviewed the manuscript

Corresponding author

Correspondence to Pablo Miranda-Lloret.

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All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee (NCR HUPLaFe 08032023] and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Miranda-Lloret, P., Simal-Julian, J.A., de San Román-Mena, L.P. et al. CSF leak after pediatric endoscopic endonasal expanded approaches: a series review. Childs Nerv Syst 40, 181–188 (2024). https://doi.org/10.1007/s00381-023-06103-y

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