Endonasal Endoscopic Transsphenoidal Approach to Lesions of the Sellar Region in Pediatric Patients.
OBJECTIVE
Endoscopic endonasal (transnasal) transsphenoidal approach (EETA) for management of sellar lesions has gained popularity as a reliable and atraumatic method. Most reported studies of EETA have focused on surgical outcome in adult patients; and there are few reports to describe outcome in pediatric patients. The authors report our early experience of 11 patients aged 14 to 18 years managed with EETA to evaluate the safety and effectiveness of EETA in the pediatric.


METHODS
Retrospective review of hospital records of 11 pediatric patients who underwent endonasal endoscopic transsphenoidal approach for resection of sellar region lesion over 2 years. Age, sex, symptoms, tumor size, extent of tumor resection, clinical outcome, and surgical complications were reviewed.


RESULTS
Total resection was achieved in 9 (81.8%) patients, subtotal resection in 2 (18.2%), and no patient had partial or insufficient resection. All (100%) patients achieved visual remission, 7 (87.5%) of 8 patients with hyperhormone preoperative had endocrinological remission. Two (18.2%) patients incurred temporary diabetes insipidus (DI) postoperatively. One (9.1%) patient incurred postoperative cerebrospinal fluid (CSF) leakage which resolved following lumbar drainage. Three (27.3%) patients developed hypopituitarism needed hormone replacement therapy. There were no cases of meningitis, intracranial hematoma, or death.


CONCLUSIONS
Endoscopic endonasal (transnasal) transsphenoidal approach (EETA) provides a safe and effective surgical option with low morbidity and mortality in pediatric patients.
*Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute at Shandong University, Jinan, Shandong, China †Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Rucai
R
Zhan
Tao
T
Xin
Xueen
X
Li
Weiguo
W
Li
Xingang
X
Li
D000293:Adolescent; D065634:Cerebrospinal Fluid Leak / Q000209:etiology; D015331:Cohort Studies; D003919:Diabetes Insipidus / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D009666:Nose / Q000601:surgery; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012074:Remission Induction; D012189:Retrospective Studies; D012449:Safety; D013129:Spinal Puncture / Q000379:methods; D016896:Treatment Outcome