Objectives: Endoscopic endonasal skull base surgical techniques, initially developed in adult patients, are being utilized with increasing frequency in pediatric patients to treat sinonasal and skull base lesions. We present our Hospital series of endoscopic endonasal approaches to the skull base to both treat disease and reconstruct the skull base in pediatric patients. Sinonasal and skull base embryology and anatomy are reviewed as a foundation for understanding the disease processes and surgical techniques.

Material and methods: A retrospective review of 6 pediatric patients who underwent EES at our institution from December 2010 to December 2015 was performed.

Results: A total of 12 EESs were performed for skull base tumors in 6 patients. Four patients (80%) were male, and the mean age at the time of surgery was 6.5 years (range 3-11 years). Skull base tumors surgery included pituitary adenomas (n = 2), chordomas (n = 5), CSF leaks (n = 3) and 2 cavernous lesions. Overall, complications included a transient diabetes insipidus in 1 patient. The mean follow-up time was 18 months.

Conclusions: The expanded endonasal approach for pediatric skull base lesions is a well tolerated and reliable method for the treatment of children with midline nasal masses. With improvements in technology and technique, this approach has become increasingly common in high-volume skull base centers as a well tolerated alternative to traditional open approaches.