title: Surgery of Anterior Skull Base Lesions in Children.
abstract: BACKGROUND
  Lesions affecting the anterior skull base represent a rare group of craniofacial pathologies. A tumor of the facial midline, meningitis, or rhinoliquorrhea may be indicative of malformations like dermoid cysts, gliomas, encephaloceles, or nasal fistulas.
  
  
  METHODS
  We present a case series of 13 children (4 months to 12 years; 8 males, 5 females) with lesions involving the anterior skull base, which were treated surgically in an interdisciplinary setting. This case series includes cases of nasal fistulae (n = 5), nasal cysts (n = 5), aneurysmal bone cyst, nasal glioma, and meningoencephalocele (n = 1).
  
  
  RESULTS
  All lesions were resected with a transnasal, transcutaneous, and/or transcranial approach with reconstruction of the anterior skull base if intracranial/intradural extension was detected. In 5 cases, a dura leakage was visible, which was sealed via Onlay-technique in 3 cases, whereas in 2 cases involving a greater dural defect, the GAP-CAS technique was performed. No complications occurred, and no recurrence was visible in a long-term follow-up. An algorithm for a systematic approach to these various pathologies is provided.
  
  
  CONCLUSIONS
  Congenital pathologies of the anterior skull base are rare, challenging to diagnose, and present as clinical emergencies. An interdisciplinary surgical approach is needed for best functional and aesthetic results.
authors.affiliation: 1 Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Ulm, Germany.
authors.forename: Thomas Karl
authors.initials: TK
authors.lastname: Hoffmann
authors.affiliation: 1 Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Ulm, Germany.
authors.forename: Marc Oliver
authors.initials: MO
authors.lastname: Scheithauer
authors.affiliation: 1 Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Ulm, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Sommer
authors.affiliation: 1 Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Ulm, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Lindemann
authors.affiliation: 2 Division of Pediatric Neurosurgery, University Medical Center, Ulm, Germany.
authors.forename: Ernst-Johannes
authors.initials: EJ
authors.lastname: Haberl
authors.affiliation: 3 Department of Obstetrics and Gynecology, Prenatal Diagnostics, University Medical Center, Ulm, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Friebe-Hoffmann
authors.affiliation: 1 Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Ulm, Germany.
authors.forename: Marie-Nicole
authors.initials: MN
authors.lastname: Theodoraki
mesh_terms: D000367:Age Factors; D017824:Bone Cysts, Aneurysmal / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003884:Dermoid Cyst / Q000175:diagnosis / Q000601:surgery*; D004677:Encephalocele / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009668:Nose Diseases / Q000175:diagnosis / Q000601:surgery*; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000601:surgery*; D019291:Skull Base / Q000601:surgery*; D016896:Treatment Outcome
keywords: aneurysmal bone cyst; dermoid sinus; encephalocele; nasal fistula; nasal glioma