{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:49:18Z","timestamp":1783079358881,"version":"3.54.6"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T00:00:00Z","timestamp":1557360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Surgical resection of skull base tumors in children is increasingly accomplished through an expanded endonasal approach (EEA). We aim to evaluate the potential effect of the EEA on midfacial growth as a result of iatrogenic damage to nasal growth zones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of children undergoing craniopharyngioma resection via an open transcranial or EEA. Pre\u2010 and postoperative magnetic resonance imaging was evaluated for growth in four midfacial measurements based on established cephalometric landmarks: anterior midface height, posterior midface height, palatal length, and sella\u2013nasion distance. Statistical analysis was conducted using a mixed\u2010effects linear regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two patients underwent an EEA (n = 12) or open transcranial approach (n = 10) for tumor resection with 3 years of imaging follow\u2010up. There was no difference in midfacial growth between groups for each measurement. Compared to the open group, patients undergoing EEA demonstrated relative anterior midface height growth of \u22120.42 mm (<jats:italic>P<\/jats:italic> = 0.880), posterior midface height growth of \u22120.44 mm (<jats:italic>P<\/jats:italic> = 0.839), palatal length growth of 0.35 mm (<jats:italic>P<\/jats:italic> = 0.894), and sella\u2013nasion distance growth of \u22122.16 (<jats:italic>P<\/jats:italic> = 0.365).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found no difference in midfacial growth measurements between patients undergoing craniopharyngioma resection via an EEA and the open transcranial route after 3 years of imaging follow\u2010up. Preliminary results on midfacial growth demonstrate that the EEA is a safe alternative to traditional transcranial approaches for the pediatric population. Further investigation with larger sample size and longer duration of follow\u2010up is warranted to more thoroughly investigate the long\u2010term implications of the EEA to the skull base.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 130:338\u2013342, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28063","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T15:37:30Z","timestamp":1557416250000},"page":"338-342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The impact of expanded endonasal skull base surgery on midfacial growth in pediatric patients"],"prefix":"10.1002","volume":"130","author":[{"given":"Arjun K.","family":"Parasher","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of South Florida  Tampa Florida 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