CSF Leak After Pediatric Endoscopic Endonasal Expanded Approaches: a Series Review

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2023 Aug 10

PMID 37561159

Authors

Pablo Miranda-Lloret

Juan Antonio Simal-Julian

Laila Perez de San Roman-Mena

Estela Plaza Ramirez

Giovanni Pancucci

Carlos Botella Asuncion

Affiliations

Soon will be listed here.

Abstract

Purpose: Endoscopic endonasal approaches in the pediatric population pose specific challenges. Management of postoperative cerebrospinal fluid [CSF] leak is probably the major concern. The purpose of the present investigation is to describe and analyze the incidence of postoperative CSF leaks in our pediatric series of endoscopic endonasal approaches.

Methods: This is a retrospective analysis, case review of our institutional series. Descriptive statistical parameters and bivariate correlations are analyzed.

Results: Twenty-one patients have been operated through endoscopic approaches in our series. Four patients showed a postoperative CSF leak needing a revision surgery; these cases are described in further detail. Approaches expanded beyond the sellar area and non-sellar pneumatization of the sphenoid sinus were significantly associated with a higher risk of postoperative CSF leak.

Conclusions: CSF leak incidence after endoscopic endonasal approaches is higher in pediatric patients than in adult series. Anatomic and pathologic factors add complexity to these approaches in children. Multilayer closure is advisable to prevent and treat this complication.

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