title: Surgical outcomes of the endoscopic transsphenoidal route to pituitary tumours in paediatric patients >10 years of age: 5 years of experience at a single institute.
abstract: OBJECTIVE
  To evaluate the safety and effectiveness of the endoscopic endonasal transsphenoidal approach (EETA) for the management of pituitary adenomas in paediatric patients >10 years of age.
  
  
  METHODS
  A retrospective chart review was performed to identify 56 paediatric patients between 10 and 18 years of age who underwent an endonasal endoscopic transsphenoidal approach for the resection of a pituitary adenoma during the last 5 years. The age, sex, symptoms, tumour size, extent of tumour resection, clinical outcome and surgical complications of patients were reviewed.
  
  
  RESULTS
  Total resection was achieved in 49 (87.5%) cases, subtotal resection was achieved in 7 (12.5%) cases and no patient had a partial or insufficient resection. Of the 35 patients who experienced preoperative deterioration of vision, 33 (94.2%) achieved visual remission with rates of 34.2% and 60% for normalisation and improvement, respectively. Endocrinological normalisation was achieved in 13 (31.7%) of 41 patients who had preoperative hyperhormonal levels; hormone levels decreased in 25 (61.0%) patients, and 3 (7.3%) patients had no change in hormone level. Two (3.5%) patients incurred postoperative cerebrospinal fluid leakage, which was resolved after lumbar drainage. Four (7.1%) patients developed hypopituitarism, which required hormone therapy. Post-surgery, five (8.9%) patients incurred transient diabetes insipidus (DI), of which one (1.7%) patient developed persistent DI and was administered Minirin. Meningitis occurred in one (1.7%) patient who was cured by the administration of a third-generation antibiotic. There were no cases of intracranial haematoma, reoperation or death.
  
  
  CONCLUSIONS
  EETA allows neurosurgeons to safely and effectively remove paediatric pituitary adenomas with low morbidity and mortality.
authors.affiliation: Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute, Shandong University, Jinan, Shandong, China.
authors.forename: Rucai
authors.initials: R
authors.lastname: Zhan
authors.affiliation: Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors.forename: Guangming
authors.initials: G
authors.lastname: Xu
authors.affiliation: Private practice, Bakersfield, California, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Wiebe
authors.affiliation: Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute, Shandong University, Jinan, Shandong, China.
authors.forename: Xingang
authors.initials: X
authors.lastname: Li
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods*; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D013101:Sphenoid Sinus; D016896:Treatment Outcome
keywords: Neurosurgery; Oncology; Paediatric Surgery