Lateral skull base surgery in a pediatric population: A 25-year experience in a referral skull base center.
OBJECTIVE
To analyze the pathology and surgical outcomes of lateral skull base (LSB) procedures in a pediatric population.


METHODS
Retrospective case review in a referral skull base center.


METHODS
Charts of pediatric patients who underwent defined LSB procedures from 1983 to 2015 for various pathologies were evaluated at our center. A systematic review of literature was performed and our results were compared with the literature.


RESULTS
63 patients presented with 65 diseased ears. The mean age was 13 years. 29 (44.6%) presented with hearing loss and 28 (44.4%) and chronic otorrhea. The most common pathology was petrous bone cholesteatoma (27, 42.5%) followed by vestibular schwannoma (10, 15.8%). Subtotal petrosectomy (24, 35.8%) was the most common surgical procedure followed by, transotic (18, 26.8%). The facial nerve function was preserved in 45 (67.1%) and the hearing in 28 (41.7%) cases respectively. No major complications, including mortality was encountered in our series.


CONCLUSIONS
In rare and extensive pathologies involving the skull base in a pediatric population, the surgeon is posed with the dilemma of trying to achieve facial and hearing preservation while dealing with total tumor clearance. Mastery over LSB procedures can ensure complete disease clearance with optimal functional outcomes.


METHODS
2b.
Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy. Electronic address: golda87@hotmail.com.
Golda
G
Grinblat
Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.
Sampath Chandra
SC
Prasad
Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.
Andrea
A
Fulcheri
Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.
Melissa
M
Laus
Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.
Alessandra
A
Russo
Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.
Mario
M
Sanna
D000293:Adolescent; D001847:Bone Diseases / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma / Q000150:complications / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000453:epidemiology; D005260:Female; D006309:Hearing; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D009464:Neuroma, Acoustic / Q000150:complications / Q000601:surgery*; D019635:Neurosurgical Procedures; D010579:Petrous Bone / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012017:Referral and Consultation; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery*; D014717:Vertigo / Q000209:etiology
Facial nerve (FN); House-Brackmann (HB) grading; LSB surgery; Pediatric; Petrous bone cholesteatoma (PBC); Subtotal petrosectomy (STP); Translabyrinthine approach (TLA); Transotic approach (TOA); Tumors; Vestibular schwannoma (VS)