{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T19:04:58Z","timestamp":1780772698615,"version":"3.54.1"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"S 03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003To evaluate the utilization of image guidance technology for pediatric transsphenoidal pituitary resection (TSPR) and analyze the complication rates, length of stay (LOS), and total cost for such surgeries as function of time and utilization of image guidance.<\/jats:p><jats:p>\n          Methods\u2003The Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) was queried for all cases of TSPR between 1997 and 2016. Factors extracted included patient demographics, use of image guidance, LOS, total cost, and complications, including panhypopituitarism, diabetes insipidus (DI), cerebrospinal fluid (CSF) rhinorrhea, and cranial nerve (CN) III, IV, and VI palsies. Multivariate logistic regression was utilized to determine the odds ratio of developing panhypopituitarism, DI, CSF rhinorrhea, and CN palsies for image-guided versus nonimage-guided cases. A generalized linear model was used to determine the effect of image guidance on inflation-adjusted total cost and LOS.<\/jats:p><jats:p>\n          Results\u2003A total of 1,297 cases of TSPR were included in the KID over this time period. The majority were female, Caucasian, and older than 15 years. Utilization of image guidance has rapidly increased since 2006. Complication rates were comparable, but when controlling for other factors, the use of image guidance showed a lower risk of postoperative DI (p\u2009=\u20090.05). The use of image guidance also resulted in a shorter LOS by 2.84 days (p\u2009&lt;\u20090.001) with no associated increase in total cost (p\u2009=\u20090.663).<\/jats:p><jats:p>\n          Conclusion\u2003The use of imaging guidance for pediatric TSPR has precipitously increased in recent years, as it is cost-effective, decreases LOS, and may lead to lower complication rates, such as DI.<\/jats:p>","DOI":"10.1055\/s-0040-1701602","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T21:07:37Z","timestamp":1585688857000},"page":"e45-e50","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016"],"prefix":"10.1055","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8923-6527","authenticated-orcid":false,"given":"Benjamin D.","family":"Lovin","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2014Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Yu","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2014Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan S.","family":"Choi","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2014Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash J.","family":"Patel","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2014Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States"},{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Giannoni","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2014Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Kelly","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2014Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2012.6.FOCUS12125","article-title":"Norman Dott, Gerard Guiot, and Jules Hardy: key players in the resurrection and preservation of transsphenoidal surgery","volume":"33","author":"S K Patel","year":"2012","journal-title":"Neurosurg Focus"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.wneu.2012.12.026","article-title":"The evolution of image guidance in transsphenoidal pituitary surgery","volume":"79","author":"G L Rosseau","year":"2013","journal-title":"World Neurosurg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/1477-7819-12-94","article-title":"Endoscopic versus 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