Pediatric Endoscopic Skull Base Surgery: Safety, Efficacy, and Lessons Learned

Area of Science:

• Neurosurgery
• Pediatric Surgery
• Otolaryngology

Background:

• Skull base surgery in children presents unique challenges.
• Minimally invasive techniques are increasingly explored for pediatric neurosurgical procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of endoscopic approaches for pediatric skull base surgery.
• To report institutional experience with endoscopic skull base procedures in patients under 18 years of age.

Main Methods:

• Retrospective review of pediatric patients (<18 years) undergoing endoscopic skull base surgery from 2016-2023.
• Analysis of surgical indications including tumors, defects, and decompression.
• Assessment of postoperative outcomes: length of stay, complications (CSF leak, infection), and long-term sequelae.

Main Results:

• 37 surgeries were performed in 32 pediatric patients.
• Common indications included tumor resection (73%) and defect repair (14%).
• Low complication rates observed: 3% CSF leak, 8% intracranial infection; no vascular or new neurological deficits. Tumor recurrence was 36% in resected tumors.

Conclusions:

• Endoscopic skull base surgery is a safe and effective treatment modality for pediatric patients.
• The technique offers favorable outcomes with manageable complication rates.
• Further research can explore long-term oncological control and functional outcomes.