scholarly journals Endoscopic Skull Base Surgery in the Pediatric Population

2021 ◽  
Author(s):  
Tara Wu ◽  
Zachariah Chandy ◽  
Elisabeth Ference ◽  
Jivianne T. Lee
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Pediatric Population ◽  
Similar Efficacy ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Invasive Approach ◽  
Safety And Efficacy ◽  
Primary Treatment Modality

Abstract Background Surgery is often indicated for definitive biopsy or as the primary treatment modality for pediatric skull base lesions. Traditionally, open surgical approaches were utilized to address pediatric skull base pathology. However recently, expanded endoscopic sinus surgery has been utilized as a minimally invasive approach to addressing skull base pathology in the pediatric population. Purpose This review provides an overview of the current literature evaluating the unique anatomic challenges of the pediatric skull and the safety and efficacy of expanded skull base procedures in the pediatric population. Findings The pediatric skull base and sinus anatomy is small and continues to develop throughout childhood leading to unique surgical challenges. Sphenoid sinus pneumatization and intercarotid distance at the skull base are two significant anatomic challenges to pediatric skull base surgery. Despite the distinctive anatomy challenges, recent studies demonstrate that the safety and efficacy of expanded endoscopic sinus surgery appear to be equivalent to traditional open surgical approaches. Conclusion Expanded endoscopic sinus surgery in the pediatric population has similar efficacy and safety as the traditional open approaches.

scholarly journals The Swansea Floating Endoscopic Assistant: A Surgical Handling Aid

Reports ◽  
2018 ◽  
Vol 1 (3) ◽  
pp. 22
Author(s):  
Jayan George ◽  
Amir Farboud ◽  
Hassan Elhassan ◽  
Heikki Whittet
Keyword(s):  
Lumbar Spine ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Mechanical Effect ◽  
The Other ◽  
Muscular Fatigue ◽  
Sinus Surgery ◽  
Double Loop ◽  
Repetitive Movements

Endoscopic sinus surgery is a rapidly advancing area of Otolaryngology. Operations can be lengthy and are often performed by a single surgeon. Repetitive movements can also lead to muscular fatigue. To mitigate against this, we regularly deploy two retractable Flexi™ compact leads, one bigger than the other connected together and suspended from the theatre operating light arm using velcro ties. The leads are then wrapped around the endoscope using a cotton crepe bandage, in a double loop with a reef knot. The larger lead attaches to the focus/zoom adjustment part of the endoscopic camera, and the smaller lead attaches to the scope 20 cm from the tip allowing the scope to float when suspended, with a slight downward tilt towards the patient. The mechanical effect this produces allows an advantageous reduction in the scope’s weight from 404 g un-suspended, to 65 g with the setup described. This subsequently reduces stress on the elbows, shoulders neck and lumbar spine. The Swansea Floating Endoscopic Assistant adheres to basic ergonomic principles and has the potential for application in other areas of Otorhinolaryngology and Skull Base Surgery.

Incidence, risk factors, and outcomes of endoscopic sinus surgery after endoscopic skull‐base surgery

2020 ◽  
Vol 10 (4) ◽  
pp. 521-525
Author(s):  
Ravi R. Shah ◽  
Ivy W. Maina ◽  
Neil N. Patel ◽  
Vasiliki Triantafillou ◽  
Alan D. Workman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Sinus Surgery ◽  
Endoscopic Skull Base Surgery ◽  
Incidence Risk

Frontal skull base surgery combined with endonasal endoscopic sinus surgery

2005 ◽  
Vol 64 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Motohiro Morioka ◽  
Jun-ichiro Hamada ◽  
Shigetoshi Yano ◽  
Yutaka Kai ◽  
Norihisa Ogata ◽  
...  
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Sinus Surgery ◽  
Frontal Skull Base

Incidence, Risk Factors, and Outcomes of Endoscopic Sinus Surgery after Endoscopic Skull Base Surgery

2019 ◽  
Author(s):  
Ravi Shah ◽  
Ivy Maina ◽  
Neil Patel ◽  
Vasiliki Triantafillou ◽  
Alan Workman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Sinus Surgery ◽  
Endoscopic Skull Base Surgery ◽  
Incidence Risk

scholarly journals Open Approaches to the Anterior Skull Base in Children: Review of the Literature

2018 ◽  
Vol 79 (01) ◽  
pp. 042-046 ◽  
Author(s):  
Ari DeRowe ◽  
Barak Ringel ◽  
Gadi Fishman ◽  
Dan Fliss ◽  
Oshri Wasserzug
Keyword(s):  
Skull Base ◽  
Endoscopic Surgery ◽  
Frontal Sinus ◽  
Skull Base Surgery ◽  
Pediatric Population ◽  
Developed Countries ◽  
Anterior Skull Base ◽  
Surgical Approaches ◽  
Endoscopic Skull Base Surgery ◽  
Skull Base Lesions

Introduction Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the “gold standard” for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods Comprehensive literature review. Results Extensive intracranial–intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a specific lesion in regard to its nature, location, and extent is of utmost importance.

scholarly journals Endoscopic Resection of Pediatric Skull Base Tumors: An Evidence-Based Review

2018 ◽  
Vol 80 (05) ◽  
pp. 527-539 ◽  
Author(s):  
Kerolos Shenouda ◽  
Brian T. Yuhan ◽  
Ahsan Mir ◽  
Nathan Gonik ◽  
Jean Anderson Eloy ◽  
...  
Keyword(s):  
Skull Base ◽  
Endoscopic Resection ◽  
Pediatric Population ◽  
Cochrane Library ◽  
Surgical Approaches ◽  
Skull Base Tumors ◽  
Nasopharyngeal Angiofibroma ◽  
Invasive Approach ◽  
Presenting Symptoms

Abstract Objectives To perform a systematic review examining experiences with endoscopic resection of skull base lesions in the pediatric population, with a focus on outcomes, recurrence, and surgical morbidities. Methods PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science databases were evaluated. Studies were assessed for level of evidence. Bias risk was evaluated using the Cochrane Bias tool, Grades of Recommendation, Assessment, Development and Evaluation (GRADE), and Methodological Index for Non-Randomized Studies (MINORS) criteria. Patient characteristics, pathology, site of primary disease, presenting symptoms, stage, procedure specific details, and complications were evaluated. Results were reported using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines. Results Ninety-three studies met criteria for inclusion, encompassing 574 patients with skull base tumors. The GRADE and MINORS criteria determined the overall evidence to be moderate quality. The most common benign and malignant pathologies included juvenile nasopharyngeal angiofibromas (n = 239) and chondrosarcomas (n = 11) at 41.6 and 1.9%, respectively. Of all juvenile nasopharyngeal angiofibroma tumors, most presented at stage IIIa and IIIb (25.8 and 27.3%, respectively). Nasal obstruction (16.5%) and headache (16.0%) were common symptoms at initial presentation. Surgical approaches included endoscopic endonasal (n = 193, 41.2%) and endoscopic extended transsphenoidal (n = 155, 33.1%). Early (< 6 weeks) and late (>6 weeks) complications included cerebrospinal fluid leak (n = 36, 17.3%) and endocrinopathy (n = 43, 20.7%). Mean follow-up time was 37 months (0.5–180 months), with 86.5% showing no evidence of disease and 2.1% having died from disease at last follow-up. Conclusion Endoscopic skull base surgery has been shown to be a safe and effective method of treating a variety of pediatric skull base tumors. If appropriately employed, the minimally invasive approach can provide optimal results in the pediatric population.

scholarly journals Complications in Skull Base Surgery and Subsequent Repair

2020 ◽  
Vol 34 (04) ◽  
pp. 286-292
Author(s):  
Weitao Wang ◽  
Tom Shokri ◽  
Spiros Manolidis ◽  
Yadranko Ducic
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Sinus Surgery ◽  
Skull Base Tumors ◽  
Viable Option ◽  
The Past ◽  
Tissue Transfer

AbstractOver the past several decades, endoscopic sinus surgery has revolutionized the approach to skull base surgery. Open skull base approaches remain a viable option for advanced skull base tumors. Complications have gone down with increased reliability of vascularized tissue transfer. In this article, the authors explore the various complications that can present following skull base surgery and review the approaches for repair when such issues are encountered.

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