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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >The impact of expanded endonasal skull base surgery on midfacial growth in pediatric patients
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The impact of expanded endonasal skull base surgery on midfacial growth in pediatric patients

机译：扩增的内鼻颅脑基础手术对儿科患者中敷脑的影响

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Objective Surgical resection of skull base tumors in children is increasingly accomplished through an expanded endonasal approach (EEA). We aim to evaluate the potential effect of the EEA on midfacial growth as a result of iatrogenic damage to nasal growth zones. Methods We performed a retrospective review of children undergoing craniopharyngioma resection via an open transcranial or EEA. Pre‐ and postoperative magnetic resonance imaging was evaluated for growth in four midfacial measurements based on established cephalometric landmarks: anterior midface height, posterior midface height, palatal length, and sella–nasion distance. Statistical analysis was conducted using a mixed‐effects linear regression model. Results Twenty‐two patients underwent an EEA (n = 12) or open transcranial approach (n = 10) for tumor resection with 3 years of imaging follow‐up. There was no difference in midfacial growth between groups for each measurement. Compared to the open group, patients undergoing EEA demonstrated relative anterior midface height growth of ?0.42 mm ( P = 0.880), posterior midface height growth of ?0.44 mm ( P = 0.839), palatal length growth of 0.35 mm ( P = 0.894), and sella–nasion distance growth of ?2.16 ( P = 0.365). Conclusion We found no difference in midfacial growth measurements between patients undergoing craniopharyngioma resection via an EEA and the open transcranial route after 3 years of imaging follow‐up. Preliminary results on midfacial growth demonstrate that the EEA is a safe alternative to traditional transcranial approaches for the pediatric population. Further investigation with larger sample size and longer duration of follow‐up is warranted to more thoroughly investigate the long‐term implications of the EEA to the skull base. Level of Evidence 3 Laryngoscope , 130:338–342, 2020
机译：通过扩展的内切纳酶方法（EEA）越来越多地完成儿童颅底肿瘤的客观手术切除。我们的目标是由于对鼻生长区的理性损伤，评估EEA对中期生长的潜在影响。方法我们对经过开放的经颅或EEA进行了对颅咽管瘤切除的儿童进行的回顾性审查。基于已建立的头部测量标志性的四个中期测量评估了预先和术后磁共振成像：前部米高度，后面的中间高度，腭长和罕见距离。使用混合效应线性回归模型进行统计分析。结果二十二名患者接受了EEA（n = 12）或开放的经颅方法（n = 10），用于3年的影像动物进行3年的肿瘤切除。每次测量之间的组之间的中期增长没有差异。与开放组相比，接受eea的患者相对前半脸高度生长α0.42 mm（p = 0.880），后部地层高度生长？0.44 mm（p = 0.839），腭长度为0.35 mm（p = 0.894） ，并罕有生长？2.16（p = 0.365）。结论我们发现，在3年的成像后续术后，通过EEA和开放的经颅术患者进行了颅咽管瘤切除患者的中期生长测量差异。中期增长的初步结果表明，EEA是对儿科人口的传统经颅途径的安全替代方案。需要进行更大的样本大小和更长的后续时间进行进一步调查，以更彻底地研究EEA对颅底的长期影响。证据水平3喉镜，130：338-342,2020

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