Endonasal endoscopic surgery for pediatric anterior cranial fossa encephaloceles: A systematic review.
Adolescent
Cerebrospinal Fluid Leak
/ etiology
Child
Child, Preschool
Cranial Fossa, Anterior
/ surgery
Encephalocele
/ surgery
Endoscopy
/ adverse effects
Humans
Hydrocephalus
/ etiology
Infant
Infant, Newborn
Intraoperative Complications
/ etiology
Meningitis
/ etiology
Neurosurgical Procedures
/ adverse effects
Nose
Postoperative Complications
/ etiology
Recurrence
Cerebrospinal fluid leak
Cerebrospinal fluid rhinorrhea
Nasal surgical procedures
Skull base neoplasms
Journal
International journal of pediatric otorhinolaryngology
ISSN: 1872-8464
Titre abrégé: Int J Pediatr Otorhinolaryngol
Pays: Ireland
ID NLM: 8003603
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
04
01
2020
revised:
28
01
2020
accepted:
30
01
2020
pubmed:
10
2
2020
medline:
17
3
2021
entrez:
10
2
2020
Statut:
ppublish
Résumé
Endoscopic endonasal skull base surgery (ESBS) is a well-established management strategy for anterior cranial fossa (ACF) encephaloceles in adults. However, its application to the pediatric population has not been evaluated in large-scale studies. This study systematically reviews the safety of ESBS for pediatric ACF encephaloceles. Articles reporting on pediatric patients undergoing purely ESBS for encephaloceles were reviewed from three databases (PubMed, Scopus, and Cochrane Library). Main outcomes were post-operative cerebrospinal fluid (CSF) leak and other surgical complications. Twenty-three articles provided data on 110 eligible patients with a mean age of 4.3 years (range birth - 18 years). Intraoperative CSF leaks occurred in 18.5% of children while post-operative CSF leaks developed in 6.0% of cases. Rates of meningitis and hydrocephalus were each 3.7%. Other complications included alar collapse, nasal stenosis, transient diabetes insipidus, pneumonia, and neurologic injury, collectively occurring in 7.0% of cases. The rate of death was 4.8%. The average duration of follow-up was 25.3 months. Encephaloceles recurred in 5.2% of patients. ESBS for pediatric ACF encephaloceles provides a relatively favorable risk-benefit profile, with a low rate of post-operative CSF leak, other surgical complications, and disease recurrence.
Sections du résumé
BACKGROUND
BACKGROUND
Endoscopic endonasal skull base surgery (ESBS) is a well-established management strategy for anterior cranial fossa (ACF) encephaloceles in adults. However, its application to the pediatric population has not been evaluated in large-scale studies. This study systematically reviews the safety of ESBS for pediatric ACF encephaloceles.
METHODS
METHODS
Articles reporting on pediatric patients undergoing purely ESBS for encephaloceles were reviewed from three databases (PubMed, Scopus, and Cochrane Library). Main outcomes were post-operative cerebrospinal fluid (CSF) leak and other surgical complications.
RESULTS
RESULTS
Twenty-three articles provided data on 110 eligible patients with a mean age of 4.3 years (range birth - 18 years). Intraoperative CSF leaks occurred in 18.5% of children while post-operative CSF leaks developed in 6.0% of cases. Rates of meningitis and hydrocephalus were each 3.7%. Other complications included alar collapse, nasal stenosis, transient diabetes insipidus, pneumonia, and neurologic injury, collectively occurring in 7.0% of cases. The rate of death was 4.8%. The average duration of follow-up was 25.3 months. Encephaloceles recurred in 5.2% of patients.
CONCLUSIONS
CONCLUSIONS
ESBS for pediatric ACF encephaloceles provides a relatively favorable risk-benefit profile, with a low rate of post-operative CSF leak, other surgical complications, and disease recurrence.
Identifiants
pubmed: 32036168
pii: S0165-5876(20)30062-8
doi: 10.1016/j.ijporl.2020.109919
pii:
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
109919Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None.