Growth of the pediatric skull base: assessment using magnetic resonance imaging.

Abstract

Minimal information is available concerning the gross anatomic changes that occur with skull base development in children. Because clinical and autopsy material to evaluate skull base growth in this population is rare, the author of this study evaluated normal magnetic resonance imaging (MRI) scans in 76 children ranging in age from newborn to 18 years. Growth of the basicranium was assessed in three dimensions: anterior-posterior, medial-lateral, and superior-inferior. In each dimension, growth was noted to be rapid until age 6 years, with relatively slower growth thereafter. In the superior-inferior and anterior-posterior dimensions, both the amount of growth and the asymptotic value were noted to be greater in males than in females (P < .05). The findings of this study can help surgeons select the appropriate operative approach for skull base masses in children. Certain approaches may involve significant morbidity, including mandibulotomy, loss of teeth, oral contamination, and external auditory canal closure. Representative cases managed through an extrapharyngeal transcervical approach are reviewed.