TY - JOUR
T1 - Outcome of Endoscopic Endonasal Surgery in Pediatric Craniopharyngiomas
AU - Mazzatenta, Diego
AU - Zoli, Matteo
AU - Guaraldi, Federica
AU - Ambrosi, Francesca
AU - Faustini Fustini, Marco
AU - Pasquini, Ernesto
AU - Asioli, Sofia
AU - Zucchelli, Mino
N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Mazzatenta Diego, Zoli Matteo, Guaraldi Federica)
PY - 2020/2
Y1 - 2020/2
N2 - Background: In the last years, few reports have shown the feasibility of the endoscopic endonasal approach (EEA) for craniopharyngiomas in pediatric patients. For these tumors, recent studies have suggested less aggressive surgery, favoring the preservation of the patient's quality of life. Objective: The aim of this study was to assess the outcome of the EEA in a large series with specific attention on the long-term functional sequelae. Materials: All consecutive pediatric craniopharyngiomas operated on through this approach since 2000 were included in the study. Preoperative and postoperative operative clinical, radiologic, and pathologic features were retrieved from patient records (mean follow-up, 72 ± 67 months). Results: The series included 25 patients (12 female; mean age, 8.9 ± 4.1 years). Most of the tumors presented with a supradiaphragmatic extension (88%). Removal was radical in 23 patients (92%). Complications consisted of 6 cerebrospinal fluid leaks (24%). One patient (4%) died of postoperative respiratory complications. Most patients (92%) developed panhypopituitarism and visual disturbances normalized or improved in 6 patients (43%). At follow-up, 9 patients (36%) were overweight/obese (6 were already overweight before surgery). The tumor recurrence rate was 19%. Conclusions: EEA can be an effective approach for midline craniopharyngiomas in children older than 3 years. It gives a satisfactory exposure of the suprasellar region and an adequate assessment of the brain–tumor interface. Its main limitations are age-related anatomic features of nasal/paranasal sinuses and the risk of cerebrospinal fluid leak.
AB - Background: In the last years, few reports have shown the feasibility of the endoscopic endonasal approach (EEA) for craniopharyngiomas in pediatric patients. For these tumors, recent studies have suggested less aggressive surgery, favoring the preservation of the patient's quality of life. Objective: The aim of this study was to assess the outcome of the EEA in a large series with specific attention on the long-term functional sequelae. Materials: All consecutive pediatric craniopharyngiomas operated on through this approach since 2000 were included in the study. Preoperative and postoperative operative clinical, radiologic, and pathologic features were retrieved from patient records (mean follow-up, 72 ± 67 months). Results: The series included 25 patients (12 female; mean age, 8.9 ± 4.1 years). Most of the tumors presented with a supradiaphragmatic extension (88%). Removal was radical in 23 patients (92%). Complications consisted of 6 cerebrospinal fluid leaks (24%). One patient (4%) died of postoperative respiratory complications. Most patients (92%) developed panhypopituitarism and visual disturbances normalized or improved in 6 patients (43%). At follow-up, 9 patients (36%) were overweight/obese (6 were already overweight before surgery). The tumor recurrence rate was 19%. Conclusions: EEA can be an effective approach for midline craniopharyngiomas in children older than 3 years. It gives a satisfactory exposure of the suprasellar region and an adequate assessment of the brain–tumor interface. Its main limitations are age-related anatomic features of nasal/paranasal sinuses and the risk of cerebrospinal fluid leak.
KW - Endoscopic endonasal approach
KW - Hypothalamus
KW - Pediatric craniopharyngioma
KW - Pituitary function
UR - http://www.scopus.com/inward/record.url?scp=85075532436&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075532436&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2019.10.039
DO - 10.1016/j.wneu.2019.10.039
M3 - Article
C2 - 31629927
AN - SCOPUS:85075532436
VL - 134
SP - e277-e288
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -