{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:33:47Z","timestamp":1789421627608,"version":"build-2803163510"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Transnasal endoscopic transsphenoidal approaches constitute an essential technique for the resection of skull base tumors in adults. However, in the pediatric population, sellar and suprasellar lesions have historically been treated by craniotomy. Transnasal endoscopic approaches are less invasive and thus may be preferable to craniotomy, especially in children. In this case series, the authors present their institutional experience with transnasal endoscopic transsphenoidal approaches for pediatric skull base tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors retrospectively reviewed pediatric patients (age \u2264 18 years) who had undergone transnasal endoscopic transsphenoidal approaches for either biopsy or resection of sellar or suprasellar lesions between 2007 and 2016. All operations were performed jointly by a team of pediatric neurosurgeons and skull base otolaryngologists, except for 8 cases performed by one neurosurgeon.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The series included 42 patients between 4 and 18 years old (average 12.5 years) who underwent 51 operations. Headache (45%), visual symptoms (69%), and symptoms related to hormonal abnormalities (71%) were the predominant presenting symptoms. Improvement in preoperative symptoms was seen in 92% of cases. Most patients had craniopharyngiomas (n = 16), followed by pituitary adenomas (n = 12), Rathke cleft cysts (n = 4), germinomas (n = 4), chordomas (n = 2), and other lesion subtypes (n = 4). Lesions ranged from 0.3 to 6.2 cm (median 2.5 cm) in their greatest dimension. Gross-total resection was primarily performed (63% of cases), with 5 subsequent recurrences. Nasoseptal flaps were used in 47% of cases, fat grafts in 37%, and lumbar drains in 47%. CSF space was entered intraoperatively in 15 cases, and postoperative CSF was observed only in lesions with suprasellar extension. There were 8 cases of new hormonal deficits and 3 cases of new cranial nerve deficits. Length of hospital stay ranged from 1 to 61 days (median 5 days). Patients were clinically followed up for a median of 46 months (range 1\u2013120 months), accompanied by a median radiological follow-up period of 45 months (range 3.8\u2013120 months). Most patients (76%) were offered adjuvant therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In this single-institution report of the transnasal endoscopic transsphenoidal approach, the authors demonstrated that this technique is generally safe and effective for different types of pediatric skull base lesions. Favorable effects of surgery were sustained during a follow-up period of 4 years. Further refinement in technology will allow for more widespread use in the pediatric population.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.4.peds18693","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T21:53:17Z","timestamp":1561153997000},"page":"246-257","source":"Crossref","is-referenced-by-count":16,"title":["Transnasal endoscopic approach for pediatric skull base lesions: a case series"],"prefix":"10.3171","volume":"24","author":[{"given":"Jennifer L.","family":"Quon","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology\u2013Head and Neck Surgery, Stanford University School of Medicine, Palo Alto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology\u2013Head and Neck Surgery, Stanford University School of Medicine, Palo Alto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald A.","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Division of Pediatric Neurosurgery, Lucile Packard Children\u2019s Hospital, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel H.","family":"Cheshier","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Division of Pediatric Neurosurgery, Lucile Packard Children\u2019s Hospital, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S. 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