Neurological Surgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, IR, Iran.
Rhinology and Skull Base Surgery, Otolaryngology Head Neck Surgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, IR, Iran.
Int J Pediatr Otorhinolaryngol. 2021 Nov;150:110902. doi: 10.1016/j.ijporl.2021.110902. Epub 2021 Sep 1.
Skull base defects in children may be the result of congenital anomalies or trauma. They often present as cerebrospinal fluid (CSF) rhinorrhea, meningitis, brain abscess or nasal obstruction. Surgical intervention is predominantly the treatment of choice. Our goal is to assess the efficacy of endoscopic endonasal approach in treating skull base defects in pediatric patients.
In this retrospective study we identified 38 patients (mean age 8.7 ± 5.6 years old, ranging 2 months-18 years) who underwent endoscopic endonasal repair of skull base defects, between March 2010 and February 2020. Patients who had skull base reconstruction after tumor resection, those who were lost to follow-up or did not sign the consent forms were excluded from the study.
The clinical indications for endoscopic endonasal repair were trauma (n = 24, 63.1%) and congenital defects (n = 14, 36.9%). Congenital skull base defects included basal meningoencephalocele (n = 5, 35.7%) and frontoethmoidal defects (n = 9, 64.3%). Mean follow up time was 32 ± 29.04 months, ranging 2-103 months. Fat graft (alone or in combination) was the most commonly used material to repair the skull base defects. Thirty-seven patients (97%) showed successful results after endoscopic endonasal surgery and were symptom free.
The endoscopic endonasal repair of CSF leak and skull base defects proved to be safe and feasible with 97% success rate.
儿童颅底缺陷可能是先天畸形或外伤的结果。它们常表现为脑脊液（CSF）鼻漏、脑膜炎、脑脓肿或鼻阻塞。手术干预主要是首选的治疗方法。我们的目标是评估内镜经鼻入路治疗儿童颅底缺陷的疗效。
在这项回顾性研究中，我们确定了 38 名（平均年龄 8.7±5.6 岁，年龄 2 个月至 18 岁）患者接受了内镜经鼻颅底缺陷修复，时间范围为 2010 年 3 月至 2020 年 2 月。排除了肿瘤切除后行颅底重建、失访或未签署同意书的患者。
内镜经鼻修复的临床指征为外伤（n=24，63.1%）和先天性缺陷（n=14，36.9%）。先天性颅底缺陷包括基底脑膜脑膨出（n=5，35.7%）和额筛骨缺陷（n=9，64.3%）。平均随访时间为 32±29.04 个月，范围为 2-103 个月。脂肪移植（单独或联合）是修复颅底缺陷最常用的材料。37 名患者（97%）经内镜经鼻手术后结果成功，且无症状。
内镜经鼻修复 CSF 漏和颅底缺陷安全可行，成功率为 97%。
