Abstract：
In this study, the authors aimed to describe the endoscopic transorbital approach (ETOA) in children.
Six pediatric patients (2 girls and 4 boys) underwent the ETOA for paramedian skull base lesions at a single institution between September 2016 and February 2023.
The median age at the time of surgery was 7.5 (range 4-18) years. The median follow-up period was 33 (range 9-60) months. In this series, the ETOA level of difficulty included stage 1 (n = 2, 33.3%), stage 3 (n = 3, 50%), and stage 5 (n = 1, 16.7%). The ETOA was performed for tumor resection in 4 cases; the final pathology consisted of fibrous dysplasia, pilocytic astrocytoma, metastatic neuroblastoma, and choroid plexus papilloma. The procedure was also performed for repair of a petrous apex meningocele and for lateral orbital wall decompression of traumatic lateral rectus muscle entrapment. One patient experienced a transient cranial nerve III palsy after the procedure. There were no operative deaths in this series.
In select cases, the ETOA can be considered a minimally invasive alternative for conventional skull base approaches in the armamentarium of pediatric skull base surgery. Further investigation and the accumulation of experience are warranted in the future to enhance the efficacy and applicability of the ETOA in pediatric patients.
Six pediatric patients (2 girls and 4 boys) underwent the ETOA for paramedian skull base lesions at a single institution between September 2016 and February 2023.
The median age at the time of surgery was 7.5 (range 4-18) years. The median follow-up period was 33 (range 9-60) months. In this series, the ETOA level of difficulty included stage 1 (n = 2, 33.3%), stage 3 (n = 3, 50%), and stage 5 (n = 1, 16.7%). The ETOA was performed for tumor resection in 4 cases; the final pathology consisted of fibrous dysplasia, pilocytic astrocytoma, metastatic neuroblastoma, and choroid plexus papilloma. The procedure was also performed for repair of a petrous apex meningocele and for lateral orbital wall decompression of traumatic lateral rectus muscle entrapment. One patient experienced a transient cranial nerve III palsy after the procedure. There were no operative deaths in this series.
In select cases, the ETOA can be considered a minimally invasive alternative for conventional skull base approaches in the armamentarium of pediatric skull base surgery. Further investigation and the accumulation of experience are warranted in the future to enhance the efficacy and applicability of the ETOA in pediatric patients.
摘要：
■在这项研究中，作者旨在描述儿童内镜经眶入路(ETOA).
方法：2016年9月至2023年2月期间，6名儿科患者（2名女孩和4名男孩）在一个机构接受了ETOA治疗副正中颅底病变。
结果：手术时的中位年龄为7.5岁（范围4-18岁）。中位随访期为33个月（9-60个月）。在这个系列中,ETOA难度水平包括第一阶段(n=2，33.3%)，阶段3(n=3，50%)，和阶段5（n=1，16.7%）。4例行ETOA肿瘤切除，最终病理为纤维异型增生，毛细胞星形细胞瘤，转移性神经母细胞瘤，和脉络丛乳头状瘤.还进行了该程序以修复岩尖脑膜膨出和外伤性外侧直肌压迫的外侧眶壁减压。一名患者在手术后经历了短暂的颅神经III麻痹。在这个系列中没有手术死亡。
结论：在某些情况下，ETOA可以被认为是小儿颅底手术中常规颅底入路的微创替代方法。将来需要进一步的研究和经验的积累，以提高ETOA在儿科患者中的疗效和适用性。
方法：2016年9月至2023年2月期间，6名儿科患者（2名女孩和4名男孩）在一个机构接受了ETOA治疗副正中颅底病变。
结果：手术时的中位年龄为7.5岁（范围4-18岁）。中位随访期为33个月（9-60个月）。在这个系列中,ETOA难度水平包括第一阶段(n=2，33.3%)，阶段3(n=3，50%)，和阶段5（n=1，16.7%）。4例行ETOA肿瘤切除，最终病理为纤维异型增生，毛细胞星形细胞瘤，转移性神经母细胞瘤，和脉络丛乳头状瘤.还进行了该程序以修复岩尖脑膜膨出和外伤性外侧直肌压迫的外侧眶壁减压。一名患者在手术后经历了短暂的颅神经III麻痹。在这个系列中没有手术死亡。
结论：在某些情况下，ETOA可以被认为是小儿颅底手术中常规颅底入路的微创替代方法。将来需要进一步的研究和经验的积累，以提高ETOA在儿科患者中的疗效和适用性。
