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Laryngoscope. 2015 Sep;125(9):2199-203. doi: 10.1002/lary.25070. Epub 2015 Jun 24.

Endoscopic endonasal surgery for benign fibro-osseous lesions of the pediatric skull base.

Author information

1
Department of Otolaryngology-Head and Neck Surgery.
2
Department of Neurological Surgery, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.

Abstract

OBJECTIVES/HYPOTHESIS:

To describe the presentation, treatment, and outcomes of benign fibro-osseous tumors involving the skull base in a pediatric population.

METHODS:

Retrospective chart review from January 2002 to September 2013 of pediatric patients (ages 0-18 years) who underwent endoscopic endonasal surgery (EES) for benign fibro-osseous tumors involving the skull base.

RESULTS:

Fourteen patients were identified with an age range of 2.7 to 17.9 years (mean, 12.5 years). Six juvenile ossifying fibromas, five benign fibro-osseous lesions, two osteomas, and one fibrous dysplasia were treated. Ocular symptoms and nasal obstruction were the most common presenting symptoms in nine (64%) and six (43%) of patients, respectively; five (36%) presented with proptosis and four (29%) with diplopia. Two (14%) patients had cranial nerve VI palsy. Transsellar and transclival approaches were used in five (36%) of patients. Orbital and optic nerve decompressions were the most common components of the approaches performed in nine (64%) of the surgeries. Gross total resection (GTR) was achieved with single-stage surgery in 10 (71%) patients; two additional patients underwent staged GTR. Two intraoperative cerebrospinal fluid (CSF) leaks occurred and were repaired endoscopically. There were no postoperative CSF leaks or infectious complications. Two patients had transient diplopia, and two had transient diabetes insipidus, all of which resolved. The mean follow-up was 13.8 months. Two patients had a recurrence, and both required additional EES achieving GTR.

CONCLUSIONS:

EES for benign fibro-osseous tumors of the skull base is a safe and effective treatment for excision of these lesions in the pediatric population.

LEVEL OF EVIDENCE:

4.

KEYWORDS:

Pediatric; endonasal surgery; endoscopic; fibro-osseous; skull base

PMID:
26108687
DOI:
10.1002/lary.25070
[Indexed for MEDLINE]

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