Endonasal Endoscopic Surgery for Pediatric Sellar and Suprasellar Lesions : A Systematic Review and Meta-analysis
OBJECTIVES: The advent of endonasal endoscopic skull base surgery (ESBS) has redefined the management of pediatric sellar and suprasellar lesions. To date, the outcomes of these procedures have not been systematically reviewed. This study performed a systematic review with meta-analysis of surgical outcomes for pediatric patients undergoing ESBS for sellar and suprasellar lesions.
DATA SOURCES: PubMed (National Library of Medicine, National Institutes of Health), Scopus (Elsevier), and Cochrane Library (Wiley).
REVIEW METHODS: Articles reporting on pediatric patients undergoing ESBS for craniopharyngiomas, pituitary adenomas, and Rathke's cleft cysts were reviewed. The primary outcome was postoperative cerebrospinal fluid (CSF) leak. Secondary outcomes included endocrine, visual, and other complications.
RESULTS: Twenty-five articles reporting on 554 patients were included. Overall postoperative CSF leak rate was 8.6%, with tumor-specific rates of 10.6% in craniopharyngiomas, 6.5% in pituitary adenomas, and 7.2% in Rathke's cleft cysts (P > .05). Older studies demonstrate higher postoperative CSF leak rates as compared with more recent studies (12.5% vs 6.1%, P = .0082). Younger children (8.9-12.6 years old) experienced a higher rate of postoperative CSF leaks as compared with older children (13.0-16.6 years old; 12.9% vs 4.9%, P = .0016). Additional postoperative complications included diabetes insipidus (26.7%), hypopituitarism (46.6%), visual deficits (2.6%), meningitis (3.4%), and weight gain (3.4%).
CONCLUSION: ESBS for pediatric sellar and suprasellar lesions is overall an effective management approach with an increasingly favorable risk-benefit profile. Younger children may be more susceptible to postoperative CSF leak as compared with older pediatric patients. Tumor type does not appear to be an independent risk factor for postoperative CSF leak in this population.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:163 |
|---|---|
| Enthalten in: |
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery - 163(2020), 2 vom: 27. Aug., Seite 284-292 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Lee, Joshua A [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Endonasal |
|---|
| Anmerkungen: |
Date Completed 10.09.2020 Date Revised 10.09.2020 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/0194599820913637 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM307907481 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM307907481 | ||
| 003 | DE-627 | ||
| 005 | 20231225130609.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/0194599820913637 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1026.xml |
| 035 | |a (DE-627)NLM307907481 | ||
| 035 | |a (NLM)32204653 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Lee, Joshua A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Endonasal Endoscopic Surgery for Pediatric Sellar and Suprasellar Lesions |b A Systematic Review and Meta-analysis |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.09.2020 | ||
| 500 | |a Date Revised 10.09.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: The advent of endonasal endoscopic skull base surgery (ESBS) has redefined the management of pediatric sellar and suprasellar lesions. To date, the outcomes of these procedures have not been systematically reviewed. This study performed a systematic review with meta-analysis of surgical outcomes for pediatric patients undergoing ESBS for sellar and suprasellar lesions | ||
| 520 | |a DATA SOURCES: PubMed (National Library of Medicine, National Institutes of Health), Scopus (Elsevier), and Cochrane Library (Wiley) | ||
| 520 | |a REVIEW METHODS: Articles reporting on pediatric patients undergoing ESBS for craniopharyngiomas, pituitary adenomas, and Rathke's cleft cysts were reviewed. The primary outcome was postoperative cerebrospinal fluid (CSF) leak. Secondary outcomes included endocrine, visual, and other complications | ||
| 520 | |a RESULTS: Twenty-five articles reporting on 554 patients were included. Overall postoperative CSF leak rate was 8.6%, with tumor-specific rates of 10.6% in craniopharyngiomas, 6.5% in pituitary adenomas, and 7.2% in Rathke's cleft cysts (P > .05). Older studies demonstrate higher postoperative CSF leak rates as compared with more recent studies (12.5% vs 6.1%, P = .0082). Younger children (8.9-12.6 years old) experienced a higher rate of postoperative CSF leaks as compared with older children (13.0-16.6 years old; 12.9% vs 4.9%, P = .0016). Additional postoperative complications included diabetes insipidus (26.7%), hypopituitarism (46.6%), visual deficits (2.6%), meningitis (3.4%), and weight gain (3.4%) | ||
| 520 | |a CONCLUSION: ESBS for pediatric sellar and suprasellar lesions is overall an effective management approach with an increasingly favorable risk-benefit profile. Younger children may be more susceptible to postoperative CSF leak as compared with older pediatric patients. Tumor type does not appear to be an independent risk factor for postoperative CSF leak in this population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a endonasal | |
| 650 | 4 | |a endoscopic | |
| 650 | 4 | |a meta-analysis | |
| 650 | 4 | |a pediatric | |
| 650 | 4 | |a sellar | |
| 650 | 4 | |a skull base | |
| 650 | 4 | |a suprasellar | |
| 700 | 1 | |a Cooper, Rebecca L |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Shaun A |e verfasserin |4 aut | |
| 700 | 1 | |a Schlosser, Rodney J |e verfasserin |4 aut | |
| 700 | 1 | |a Gudis, David A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |d 1982 |g 163(2020), 2 vom: 27. Aug., Seite 284-292 |w (DE-627)NLM012595721 |x 1097-6817 |7 nnns |
| 773 | 1 | 8 | |g volume:163 |g year:2020 |g number:2 |g day:27 |g month:08 |g pages:284-292 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/0194599820913637 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 163 |j 2020 |e 2 |b 27 |c 08 |h 284-292 | ||