Special Considerations in Pediatric Endoscopic Skull Base Surgery

Bastien A Valencia-Sanchez; Jeeho D Kim; Sheng Zhou; Sonja Chen; Michael L Levy; Christopher Roxbury; Vijay A Patel; Sean P Polster

doi:10.3390/jcm13071924

Special Considerations in Pediatric Endoscopic Skull Base Surgery

J Clin Med. 2024 Mar 26;13(7):1924. doi: 10.3390/jcm13071924.

Authors

Bastien A Valencia-Sanchez¹, Jeeho D Kim², Sheng Zhou³, Sonja Chen⁴, Michael L Levy^{5

6}, Christopher Roxbury⁷, Vijay A Patel^{8

9}, Sean P Polster⁴

Affiliations

¹ School of Medicine and Health Sciences TecSalud, Tecnologico de Monterrey, Monterrey 64710, Mexico.
² Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center San Diego, San Diego, CA 92134, USA.
³ USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA 90033, USA.
⁴ Department of Neurosurgery, University of Chicago, Chicago, IL 60637, USA.
⁵ Division of Pediatric Neurosurgery, Rady Children's Hospital, San Diego, CA 92123, USA.
⁶ Department of Neurosurgery, University of California San Diego, La Jolla, CA 92093, USA.
⁷ Department of Surgery, Section of Otolaryngology, University of Chicago Medicine, Chicago, IL 60637, USA.
⁸ Division of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, CA 92123, USA.
⁹ Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, La Jolla, CA 92093, USA.

Abstract

Originally pioneered in adults, endoscopic endonasal approaches for skull base pathology are being increasingly applied as a minimally invasive alternative for young children. Intrinsic anatomic differences between these patient populations have sparked discussions on the feasibility, safety, and efficacy of these techniques in pediatric patients. This work aims to serve as a primer for clinicians engaged in the rapidly evolving field of pediatric endoscopic skull base surgery. A succinct overview of relevant embryology, sinonasal anatomy, and diagnostic workup is presented to emphasize key differences and unique technical considerations. Additional discussions regarding select skull base lesions, reconstructive paradigms, potential surgical complications, and postoperative care are also highlighted in the setting of multidisciplinary teams.

Keywords: endonasal; endoscopic; multidisciplinary team; pediatric; reconstruction; skull base surgery; technical considerations.

Publication types

Review

Grants and funding

This work was supported by the Safadi Program of Excellence in Clinical and Translational Neuroscience at the University of Chicago, the North American Skull Base Society, the American College of Surgeons, and the Neurosurgeon Research Career Development Program.