Pedicled nasoseptal flap reconstruction for craniopharyngiomas in pediatric patients
| Autor: | Mark A. Mittler, Mark J. Shikowitz, Anya Laibangyang, Shanna L. Baron, Steven J. Schneider, B. Todd Schaeffer, Shaun Rodgers |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Sphenoid bone Surgical Flaps Resection Craniopharyngioma 03 medical and health sciences 0302 clinical medicine Humans Medicine Pituitary Neoplasms Child Sinus (anatomy) Retrospective Studies Skull Base medicine.diagnostic_test business.industry Endoscopy Magnetic resonance imaging Retrospective cohort study General Medicine Plastic Surgery Procedures medicine.disease medicine.anatomical_structure Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Neurology (clinical) Radiology Neurosurgery business 030217 neurology & neurosurgery Pediatric population |
| Zdroj: | Child's Nervous System. 36:491-496 |
| ISSN: | 1433-0350 0256-7040 |
| DOI: | 10.1007/s00381-019-04238-5 |
| Popis: | Though the use of the pedicled nasoseptal flap (NSF), a reconstructive technique used after endoscopic endonasal approaches (EEA) for resection of craniopharyngiomas, has been shown to reduce the occurrence of post-operative cerebrospinal fluid (CSF) leaks in adults, less is known about its use in pediatric populations, specifically in children under the age of 7. The goal of this retrospective cohort study is to determine the viability of the pedicled NSF for pediatric patients. Retrospective review of 12 pediatric patients (ages 2–16) undergoing 13 NSF reconstructions after resection of craniopharyngiomas. Radioanatomic analysis of computed tomography (CT) scans was utilized to classify the pneumatization of the sphenoid sinus depending on the thickness of the sphenoid bone margin. Intercarotid distances were measured from magnetic resonance imaging (MRI) scans to assess the feasibility of this reconstruction technique in pediatric patients. At the time of surgery, all patients were noted to have adequate NSF length and width. No post-operative high-flow CSF leaks were found within the group. Lack of pneumatization of the sphenoid sinus and narrow intercarotid distances in the youngest of patients did not lead to negative clinical outcomes. Based on our results and experience, the pedicled nasoseptal flap is a viable reconstructive option after EEA in the pediatric population, including even the youngest of patients. In these patients, a narrowed window between the intercarotid arteries and the lack of pneumatization of the sphenoid sinus present a challenge that can be overcome by using stereotactic navigation and advanced endoscopic techniques. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink