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Application of skull base techniques to pediatric neurosurgery
1Center for Skull Base Surgery, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock 72202, USA. TeoCharles@exchange.uams.edu
Summary
Skull base surgery in pediatric patients is rare but effective for tumor resection. While complications occur, complete tumor removal was achieved in most cases, demonstrating the value of these advanced surgical techniques.
Area of Science:
- Neurosurgery
- Pediatric Oncology
Background:
- Skull base surgery techniques are established primarily for adult patients.
- Pediatric skull base tumors are rare, limiting large-scale study data.
- This study presents a significant series of pediatric skull base tumor resections.
Observation:
- Twenty-six pediatric patients underwent skull base approaches for tumor resection.
- Tumors were located in the anterior (5), medial (4), and posterior (12) cranial bases, with 5 involving multiple fossae.
- The overall complication rate was 57%, including temporary nerve palsies, CSF leaks, and infections.
Findings:
- Complete tumor removal was achieved in 24 of 26 pediatric patients.
- Permanent complications occurred in 37% of patients.
- One postoperative death occurred due to pneumonia approximately 6 weeks after surgery.
Implications:
- Skull base approaches are effective for pediatric tumors, despite challenges.
- Surgical morbidity is often associated with achieving complete tumor extirpation in children.
- This study highlights the effectiveness and inherent risks of skull base surgery in pediatric oncology.