Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in Children
ObjectiveTo explore the surgical approach and technique of neuroendoscopic endonasal resection of pediatric craniopharyngiomas and to further evaluate its safety and effect in children.MethodsThe clinical data of 8 children with craniopharyngiomas who were surgically treated by neuroendoscopy throug...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.771236/full |
| _version_ | 1818715859514818560 |
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| author | Danyang Wu Ling Xu Sungel Xie Feiji Sun Mingxiang Xie Mingxiang Xie Pei Wang Shunwu Xiao Shunwu Xiao |
| author_facet | Danyang Wu Ling Xu Sungel Xie Feiji Sun Mingxiang Xie Mingxiang Xie Pei Wang Shunwu Xiao Shunwu Xiao |
| author_sort | Danyang Wu |
| collection | DOAJ |
| description | ObjectiveTo explore the surgical approach and technique of neuroendoscopic endonasal resection of pediatric craniopharyngiomas and to further evaluate its safety and effect in children.MethodsThe clinical data of 8 children with craniopharyngiomas who were surgically treated by neuroendoscopy through an extended endonasal approach in our center from 2018 to 2021 were retrospectively analyzed. The related surgical approach and technique were evaluated to improve the surgical results and further reduce the surgical complications when removing craniopharyngioma in children.ResultsAll 8 patients achieved a gross-total resection of the tumor under neuroendoscopy. Postoperatively, 2 cases of transient hyperthermia and 4 cases of transient hyper- and/or hyponatremia occurred within the first 2 weeks, all of which were quickly controlled. Seven patients had symptoms of diabetes insipidus to varying degrees after the operation, and 4 of them improved within 1–3 months after surgery, but 3 cases still needed oral pituitrin. There were no cases of coma or death, leakage of cerebrospinal fluid, or severe electrolyte imbalance after surgery. During the postoperative follow-up of 3 months to 2 years, no tumor recurrence was found. Among the 7 patients who suffered postoperative neuroendocrine deficiencies, 3 patients were found to be temporary during the follow-up, but 4 patients still required hormone replacement therapy. Particularly, postoperative visual deterioration and olfactory defect that occurred in patients were all improved during follow-up periods. In addition, 4 cases of obesity were noted at the last follow-up.ConclusionsExtended neuroendoscopic endonasal resection of craniopharyngiomas may be used as a safe and effective approach for children. Due to the poor pneumatization of the sphenoid sinus and worse compliance of treatment in children, surgical techniques of exposing the sellar region, removing the tumor, and reconstructing the skull base, as well as postoperative management of patients was proposed. However, due to the limited surgical cases in the study, the surgical safety and effects of the extended neuroendoscopic endonasal approach for children with craniopharyngiomas need to be further studied in the future. |
| first_indexed | 2024-12-17T19:10:04Z |
| format | Article |
| id | doaj.art-be910f87a3844e7c9824dceaadbaa6bf |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-17T19:10:04Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-be910f87a3844e7c9824dceaadbaa6bf2022-12-21T21:35:53ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-01-011310.3389/fneur.2022.771236771236Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in ChildrenDanyang Wu0Ling Xu1Sungel Xie2Feiji Sun3Mingxiang Xie4Mingxiang Xie5Pei Wang6Shunwu Xiao7Shunwu Xiao8Department of Neurosurgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Neurosurgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Neurosurgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Neurosurgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Neurosurgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaGraduate School, Zunyi Medical University, Zunyi, ChinaDepartment of Neurosurgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Neurosurgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaGraduate School, Zunyi Medical University, Zunyi, ChinaObjectiveTo explore the surgical approach and technique of neuroendoscopic endonasal resection of pediatric craniopharyngiomas and to further evaluate its safety and effect in children.MethodsThe clinical data of 8 children with craniopharyngiomas who were surgically treated by neuroendoscopy through an extended endonasal approach in our center from 2018 to 2021 were retrospectively analyzed. The related surgical approach and technique were evaluated to improve the surgical results and further reduce the surgical complications when removing craniopharyngioma in children.ResultsAll 8 patients achieved a gross-total resection of the tumor under neuroendoscopy. Postoperatively, 2 cases of transient hyperthermia and 4 cases of transient hyper- and/or hyponatremia occurred within the first 2 weeks, all of which were quickly controlled. Seven patients had symptoms of diabetes insipidus to varying degrees after the operation, and 4 of them improved within 1–3 months after surgery, but 3 cases still needed oral pituitrin. There were no cases of coma or death, leakage of cerebrospinal fluid, or severe electrolyte imbalance after surgery. During the postoperative follow-up of 3 months to 2 years, no tumor recurrence was found. Among the 7 patients who suffered postoperative neuroendocrine deficiencies, 3 patients were found to be temporary during the follow-up, but 4 patients still required hormone replacement therapy. Particularly, postoperative visual deterioration and olfactory defect that occurred in patients were all improved during follow-up periods. In addition, 4 cases of obesity were noted at the last follow-up.ConclusionsExtended neuroendoscopic endonasal resection of craniopharyngiomas may be used as a safe and effective approach for children. Due to the poor pneumatization of the sphenoid sinus and worse compliance of treatment in children, surgical techniques of exposing the sellar region, removing the tumor, and reconstructing the skull base, as well as postoperative management of patients was proposed. However, due to the limited surgical cases in the study, the surgical safety and effects of the extended neuroendoscopic endonasal approach for children with craniopharyngiomas need to be further studied in the future.https://www.frontiersin.org/articles/10.3389/fneur.2022.771236/fullcraniopharyngiomachildrensurgical techniqueneuroendoscopyendonasal approach |
| spellingShingle | Danyang Wu Ling Xu Sungel Xie Feiji Sun Mingxiang Xie Mingxiang Xie Pei Wang Shunwu Xiao Shunwu Xiao Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in Children Frontiers in Neurology craniopharyngioma children surgical technique neuroendoscopy endonasal approach |
| title | Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in Children |
| title_full | Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in Children |
| title_fullStr | Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in Children |
| title_full_unstemmed | Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in Children |
| title_short | Extended Neuroendoscopic Endonasal Approach for Resection of Craniopharyngioma in Children |
| title_sort | extended neuroendoscopic endonasal approach for resection of craniopharyngioma in children |
| topic | craniopharyngioma children surgical technique neuroendoscopy endonasal approach |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.771236/full |
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