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Updated: Jan 6, 2026
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Cushing's disease in children: a single-centre experience
Ahmed Mahmoud Elnaggar1, Mehul Dattani2, Hoong-Wei Gan2
1Department of Neurosurgery, Great Ormond Street Hospital, London, UK. Ahmed.Elnaggar5@nhs.net.
Summary
Paediatric Cushing's disease (CD) is often diagnosed late, but transsphenoidal surgery (TSS) offers effective treatment outcomes. Early diagnosis and a multidisciplinary approach are key for managing pediatric CD.
Area of Science:
- Pediatric Endocrinology
- Neurosurgery
- Pediatric Endocrinology
Background:
- Cushing's disease (CD) in children presents unique diagnostic and management challenges.
- Delayed diagnosis in pediatric CD is common, often associated with significant comorbidities like growth failure.
Purpose of the Study:
- To review institutional experience with pediatric Cushing's disease over 15 years.
- To determine surgical outcomes and complications in children with CD.
Main Methods:
- Retrospective review of clinical data, neuroradiology, and outcomes for pediatric CD patients undergoing surgery (2006-2023).
- Analysis of transsphenoidal surgery (TSS) approaches (microscopic vs. endoscopic).
Main Results:
- 25 children (mean age 11.8 years) underwent surgery for CD; 70% experienced growth failure.
- Transsphenoidal surgery (TSS) achieved 76% biochemical remission, with no significant difference between microscopic and endoscopic techniques.
- Postoperative complications included transient diabetes insipidus (6 cases) and CSF rhinorrhoea (3 cases).
Conclusions:
- Pediatric Cushing's disease is frequently diagnosed late, despite characteristic symptoms.
- Transsphenoidal surgery (TSS) is an effective treatment for pediatric CD, comparable to adult outcomes.
- A multidisciplinary team approach is essential for optimal management of pediatric CD.
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