Anatomical considerations for endoscopic endonasal skull base surgery in pediatric patients

Objectives/Hypothesis: Pediatric skull base surgery is limited by several boney sinonasal landmarks that must be overcome prior to tumor dissection. When approaching a sellar or parasellar tumor, the piriform aperture, sphenoid sinus pneumatization, and intercarotid distances are areas of potential...

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Bibliographic Details
Published in:The Laryngoscope 2010-09, Vol.120 (9), p.1730-1737
Main Authors: Tatreau, Jason R., Patel, Mihir R., Shah, Rupali N., McKinney, Kibwei A., Wheless, Stephen A., Senior, Brent A., Ewend, Matthew G., Germanwala, Anand V., Ebert Jr, Charles S., Zanation, Adam M.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Anatomy, Cross-Sectional
Biological and medical sciences
Carotid Artery, Internal - diagnostic imaging
Carotid Artery, Internal - surgery
Cephalometry - methods
Child
Child, Preschool
Endoscopic skull base surgery
Endoscopy - methods
Female
Humans
Infant
intercarotid distance
Level of Evidence: 4
Male
Medical sciences
Otorhinolaryngology. Stomatology
pediatric skull base surgery
Pituitary Gland - anatomy & histology
Pituitary Gland - diagnostic imaging
Pituitary Gland - surgery
pituitary surgery
Pyriform Sinus - anatomy & histology
Pyriform Sinus - diagnostic imaging
Pyriform Sinus - surgery
radio-anatomic study
Reference Values
Skull Base - anatomy & histology
Skull Base - diagnostic imaging
Skull Base - surgery
sphenoid
Sphenoid Sinus - anatomy & histology
Sphenoid Sinus - surgery
Tomography, X-Ray Computed
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Summary:Objectives/Hypothesis: Pediatric skull base surgery is limited by several boney sinonasal landmarks that must be overcome prior to tumor dissection. When approaching a sellar or parasellar tumor, the piriform aperture, sphenoid sinus pneumatization, and intercarotid distances are areas of potential limitation. Quantitative pediatric anatomical measurements relevant to skull base approaches are lacking. Our goal was to use radio‐anatomic analysis of computed tomography scans to determine anatomical limitations for trans‐sphenoidal approaches in pediatric skull base surgery. Study Design: A radio‐anatomic cross‐sectional survey. Methods: Measurements included the diameter of the piriform aperture, posterior extent of sphenoid sinus pneumatization, and intercarotid distances on fine‐cut, age‐stratified maxillofacial scans. Fifty pediatric (
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.20964