{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:26:05Z","timestamp":1792167965706,"version":"4.4.0"},"reference-count":60,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T00:00:00Z","timestamp":1585008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>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\u2010analysis of surgical outcomes for pediatric patients undergoing ESBS for sellar and suprasellar lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed (National Library of Medicine, National Institutes of Health), Scopus (Elsevier), and Cochrane Library (Wiley).<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>Articles reporting on pediatric patients undergoing ESBS for craniopharyngiomas, pituitary adenomas, and Rathke\u2019s cleft cysts were reviewed. The primary outcome was postoperative cerebrospinal fluid (CSF) leak. Secondary outcomes included endocrine, visual, and other complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010five articles reporting on 554 patients were included. Overall postoperative CSF leak rate was 8.6%, with tumor\u2010specific rates of 10.6% in craniopharyngiomas, 6.5% in pituitary adenomas, and 7.2% in Rathke\u2019s cleft cysts (<jats:italic>P<\/jats:italic> &gt;. 05). Older studies demonstrate higher postoperative CSF leak rates as compared with more recent studies (12.5% vs 6.1%, <jats:italic>P<\/jats:italic> =. 0082). Younger children (8.9\u201012.6 years old) experienced a higher rate of postoperative CSF leaks as compared with older children (13.0\u201016.6 years old; 12.9% vs 4.9%, <jats:italic>P<\/jats:italic> =. 0016). Additional postoperative complications included diabetes insipidus (26.7%), hypopituitarism (46.6%), visual deficits (2.6%), meningitis (3.4%), and weight gain (3.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ESBS for pediatric sellar and suprasellar lesions is overall an effective management approach with an increasingly favorable risk\u2010benefit 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.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820913637","type":"journal-article","created":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T04:24:30Z","timestamp":1585023870000},"page":"284-292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Endonasal Endoscopic Surgery for Pediatric Sellar and Suprasellar Lesions: A Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"163","author":[{"given":"Joshua A.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca L.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical 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