{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:19:01Z","timestamp":1790381941218,"version":"4.1.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Scarce morphometric data exist on the developing skull base as a corridor for endonasal endoscopic approaches (EEAs). Furthermore, the impact of skull base lesions on its development has not been assessed. The authors describe a novel set of anatomical parameters characterizing the developmental process as well as the utility of these parameters in preoperative planning and a feasibility assessment of EEAs for neurosurgical treatment of skull base lesions in children.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Based on specific MRI sequences in 107 pediatric patients (2\u201316 years of age) without skull base lesions (referred to here as the normal population), 3 sets of anatomical parameters were analyzed according to age group and sex: drilling distance, restriction sites, and working distance parameters. A separate set of patients undergoing EEAs was analyzed in similar fashion to address the impact of skull base lesions on the developmental process.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The volume of the sphenoid sinus significantly increases with age, reaching 6866.4 mm<jats:sup>3<\/jats:sup> in the 14\u201316 years age group, and directly correlates with the pneumatization type (r = 0.533, p = 0.0001). The pneumatization process progresses slowly in a temporal-posterior direction, as demonstrated by the growth trend of the sellar width (r = 0.428, p = 0.0001). Nasal restriction sites do not change significantly with age, with little impact on EEAs. The intercarotid distance is significantly different only in the extreme age groups (3.9 mm, p = 0.038), and has an important impact on the transsphenoidal angle and the intracranial dissection limits (r = 0.443, p &lt; 0.0001). The 14.9\u00b0 transsphenoidal angle at 2\u20134 years has a 37.6% significant increase in the 11\u201313 years age group (p = 0.001) and is highly dependent on pneumatization type. Age-dependent differences between working parameters are mostly noted for the extreme age groups, such as the 8.6-mm increase in nare-vomer distance (p = 0.025). The nare-sellar distance is the only parameter with significant differences based on sex. Skull base lesions induce a high degree of variance in skull base measurements, delaying development and decreasing parameter values. Skull base parameters are interdependent. Nare-sellar distance can be used to assess global skull base development because it highly correlates with the intercarotid distance in both the normal population and in patients harboring skull base lesions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Skull base development is a slow, gradual, age-dependent, sex-independent process significantly altering endonasal endoscopic corridors. Preoperative MRI measurements of the pediatric skull base are thus a useful adjunct in choosing the appropriate corridor and in assessing working angles and limits during dissection or reparative surgery. Skull base lesions can significantly impact normal skull base development and age-dependent growth patterns.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.10.peds13303","type":"journal-article","created":{"date-parts":[[2013,12,6]],"date-time":"2013-12-06T15:13:30Z","timestamp":1386342810000},"page":"155-169","source":"Crossref","is-referenced-by-count":61,"title":["Impact of skull base development on endonasal endoscopic surgical corridors"],"prefix":"10.3171","volume":"13","author":[{"given":"Matei A.","family":"Banu","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amancio","family":"Guerrero-Maldonado","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather J.","family":"McCrea","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Garcia-Navarro","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark M.","family":"Souweidane","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2014Head and Neck Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Heier","sequence":"additional","affiliation":[{"name":"Radiology, Weill Cornell Medical College, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Otolaryngology\u2014Head and Neck Surgery,"},{"name":"Neurology and Neuroscience, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds13303","series-title":"Eur Radiol","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1007\/s00330-001-1218-9","article-title":"Paranasal sinuses in children: size evaluation of maxillary, sphenoid, and frontal sinuses by magnetic resonance imaging and proposal of volume index percentile curves","volume":"12","author":"Barghouth","year":"2002"},{"key":"b2-peds13303","series-title":"Rhinology","first-page":"162","article-title":"Evaluation of some important anatomical variations and dangerous areas of the paranasal sinuses by CT for safer endonasal surgery","volume":"36","author":"Ba\u015fak","year":"1998"},{"issue":"6 Suppl 3","key":"b3-peds13303","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1227\/01.NEU.0000333786.98596.33","article-title":"Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: anatomic considerations\u2014part 1","volume":"62","author":"Cavallo","year":"2008"},{"key":"b4-peds13303","series-title":"J Neurosurg Pediatr","first-page":"227","article-title":"Endoscopic endonasal skull base surgery in the pediatric population. 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