[Endoscopic Transnasal Surgery for Pediatric Brain Tumors]

Area of Science:

• Pediatric Neurosurgery
• Skull Base Surgery
• Minimally Invasive Surgery

Background:

• Pediatric brain tumors present distinct biological and anatomical challenges compared to adult tumors.
• Endoscopic transnasal skull base surgery (ETS) is increasingly used in children for sellar and parasellar lesions, offering a minimally invasive ventral corridor.

Purpose of the Study:

• To review the application, challenges, and outcomes of endoscopic transnasal skull base surgery (ETS) in pediatric patients.
• To highlight the unique considerations and multidisciplinary approach required for pediatric ETS.

Main Methods:

• Review of current literature and clinical experience with pediatric endoscopic transnasal skull base surgery.
• Discussion of specific pediatric anatomical constraints, surgical limitations, and perioperative risks.

Main Results:

• Pediatric ETS faces challenges like underdeveloped sinuses, difficulty with postoperative rest, potential impact on growth plates, and risk of intracranial pressure elevation.
• Despite challenges, advances in technology and multilayer reconstruction allow outcomes comparable to adult ETS.
• Pediatric ETS is applicable to a wide range of tumors, including craniopharyngiomas, germ cell tumors, and optic pathway gliomas, with growing value in molecular diagnosis via biopsy.

Conclusions:

• Pediatric endoscopic transnasal skull base surgery is a viable, minimally invasive approach for various brain tumors.
• Successful pediatric ETS necessitates careful perioperative management addressing pediatric-specific risks and a collaborative multidisciplinary team effort.