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Endoscopic endonasal management of encephaloceles in children: an eight-year experience
Paolo Castelnuovo1, Maurizio Bignami, Andrea Pistochini
1Department of Otorhinolaryngology, University of Insubria, Varese, Azienda Ospedaliero Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Insights
Endoscopic endonasal repair is a safe and effective treatment for pediatric skull base encephaloceles. This minimally invasive approach offers successful outcomes for children with these complex congenital defects.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Endoscopic Skull Base Surgery
Background:
- Skull base encephaloceles present diagnostic and therapeutic challenges.
- Traditional external craniotomy approaches are invasive.
- Endoscopic endonasal repair is the standard for adult skull base defects.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscopic endonasal repair for pediatric basal encephaloceles.
- To assess the feasibility of this minimally invasive technique in a pediatric population.
Main Methods:
- Retrospective analysis of pediatric patients undergoing endoscopic endonasal repair of encephaloceles.
- Study conducted at a tertiary referral center.
- Inclusion criteria based on diagnosis and treatment method.
Main Results:
- Eleven pediatric patients met the study criteria.
- Mean age at surgery was 6.1 years, with a mean follow-up of 46.5 months.
- Most encephaloceles were located in the anterior cranial fossa; all cases were managed successfully without complications.
Conclusions:
- Endonasal endoscopic management is a feasible and safe option for congenital encephaloceles in children.
- Thorough pre-operative neuroimaging is crucial for successful surgical planning and execution.
- This technique offers a less invasive alternative to traditional surgical approaches for pediatric skull base defects.
Objective:
Skull base encephaloceles are difficult to diagnose and to treat. Traditionally, they are approached externally via craniotomic routes. Endoscopic management of skull base defects is the standard treatment in adults. Our aim is to evaluate the efficacy and safety of endoscopic endonasal repair of basal encephaloceles in the paediatric population.
Methods:
Retrospective evaluation of paediatric encephaloceles managed endoscopically at a tertiary referral centre.
Results:
Eleven subjects fitted the criteria of the study. Mean age at surgery was 6.1+/-4.6 SD years, while mean follow-up was 46.5+/-28 SD months. Most of the defects were located in the anterior cranial fossa. All patients were managed successfully with no complications.
Conclusions:
Endonasal endoscopic management of congenital encephaloceles is feasible in paediatric patients. Meticulous pre-op neuroimaging is of paramount importance when dealing with such cases.
