Purpose

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.

Material and methods

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.

Results

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.

Conclusion

The endoscopic endonasal repair of CSF leak and skull base defects proved to be safe and feasible with 97% success rate.

中文翻译：

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儿科患者颅底缺损的内镜鼻内治疗

目的

儿童的颅底缺陷可能是先天异常或外伤的结果。它们通常表现为脑脊液 (CSF) 鼻漏、脑膜炎、脑脓肿或鼻塞。手术干预是主要的治疗选择。我们的目标是评估内窥镜鼻内入路治疗儿科患者颅底缺损的疗效。

材料与方法

在这项回顾性研究中，我们确定了 2010 年 3 月至 2020 年 2 月期间接受内窥镜鼻内修复颅底缺损的 38 名患者（平均年龄 8.7 ± 5.6 岁，范围为 2 个月至 18 岁）。 肿瘤切除后进行颅底重建的患者，那些失访或没有签署同意书的人被排除在研究之外。

结果

内窥镜鼻内修复的临床适应症为外伤（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。脂肪移植物（单独或组合）是修复颅底缺损最常用的材料。37 名患者 (97%) 在内窥镜鼻内手术后取得了成功，并且没有任何症状。

结论

脑脊液漏和颅底缺损的内窥镜鼻内修复被证明是安全可行的，成功率为 97%。