Management of Pediatric Sinonasal and Skull Base Lesions

Abstract

Pediatric sinonasal and skull base lesions are rare and complex disorders. The safe and comprehensive management of this diverse group of pathologies requires the expertise of an experienced multidisciplinary skull base team. With significant evolution and improved outcomes achieved in adult endoscopic skull base surgery (ESBS), similar principles have been applied to the pediatric population. Pediatric endoscopic surgery for sinonasal and skull base tumors has therefore also evolved due to a variety of technologic and surgical advances, multidisciplinary team approaches, and continued innovation. Pediatric sinonasal and skull base tumors require complex multidisciplinary management for optimal outcome. Detailed understanding of the sinonasal anatomy will improve surgical outcomes. The surgical approaches and techniques are dependent on the location of the lesion, the pathology, extent of disease, and surgical goals. Reconstruction following tumor extirpation follows the same principles as adult reconstruction, with the ultimate goal of achieving a watertight seal that separates the nasal cavity from the brain. Complications can be catastrophic and rely on immediate recognition and management to prevent long-term sequelae.