Anatomical Parameters and Growth of the Pediatric Skull Base: Endonasal Access Implications (2023)

FAQs

What is a skull base tumor in a child? ›

Key points about skull base rhabdomyosarcoma in children

A skull base rhabdomyosarcoma is cancer that forms in the head and neck. Symptoms include problems with the sense of smell, eye sight, hearing, swallowing, and facial weakness. Treatment includes surgery, chemotherapy, and radiation therapy.

The ventral skull base can be classified into two planes—sagittal and coronal—with the sella turcica as the center. The coronal plane indicates the area located lateral to the sella turcica, i.e., the ventrolateral skull base.

The Endoscopic Endonasal Approach is an innovative surgical technique used to remove brain tumors and lesions—some as large as softballs—all through the nose.

The expanded endonasal approach describes a series of surgical modules in the sagittal and coronal planes that allow surgical access to the entire ventral skull base. The sagittal plane extends from the frontal sinus to the second cervical vertebra.

A skull base tumor is an abnormal growth in the part of the brain that meets the base of the skull. Most skull base tumors are benign (not cancerous) and don't spread to other parts of the body. But even benign ones, which grow slowly, can cause serious damage.

Skull base tumors most often grow inside the skull but occasionally form on the outside. They can originate in the skull base as a primary tumor or spread there from a cancer elsewhere in the body as a metastatic brain tumor. Skull base tumors are classified by tumor type and location within the skull base.

Endoscopic endonasal surgery can be used to remove tumors in areas near the base of the brain or skull, and at the top of the spine. It can also be used to treat problems with the sinuses. This approach allows the surgeon to reach these areas without the need for large incisions or removal of parts of the skull.

Surgical approaches for skull base tumors include the following: modified orbitozygomatic, pterional, middle fossa, retrosigmoid, far lateral craniotomy, and midline suboccipital craniotomy. Typically, complete surgical extirpation of osteomas is curative; if the mass is large, skull reconstruction may be necessary.

The Endoscopic Endonasal Approach is a minimally invasive surgical approach to the skull base that was refined and is performed at UPMC by a multidisciplinary surgical team to remove skull base brain tumors and lesions through the nose. EEA is performed using a narrow telescope called an endoscope.

The European Economic Area ( EEA )

The EEA includes EU countries and also Iceland, Liechtenstein and Norway. It allows them to be part of the EU 's single market. Switzerland is not an EU or EEA member but is part of the single market.

Why does the EEA exist? ›

The European Economic Area (EEA) was established by the EEA Agreement, which entered into force in 1994. Its objective is to extend the Internal Market of the EU to the three participating EFTA States creating a homogeneous European Economic Area.

The EEA Agreement does not cover the following EU policies: common agriculture and fisheries policies (although the EEA Agreement contains provisions on trade in agricultural and fish products); customs union; common trade policy; common foreign and security policy; justice and home affairs (the EEA EFTA States are ...

The Endoscopic Endonasal Approach (EEA) is an innovative surgical technique used to remove brain tumors and lesions—some as large as softballs—all through the nose.

It will take 6 to 8 weeks for your nose to heal completely. You may feel tired for 7 to 10 days after surgery. The amount of activity you can do will depend on your healing. You should limit activities such as walking and climbing stairs for the first 2 days after you leave the hospital.

The different planes that Radiologists use are axial (divides the body into top and bottom halves), coronal (perpendicular), and sagittal (midline of the body). Radiologists call images that are axial or coronal view differently as they reverse left and right.

Many skull base tumors can be removed with minimally invasive approaches, which do not require making incisions through the skull. Sometimes, due to a tumor's location or size, it may need to be removed through open surgery, called craniotomy.

Generally, benign tumours are more common in skull base region and the survival is very good for such benign tumours like meningiomas. Chordomas are more aggressive and malignant tumours and five-year survival is around 70 per cent.

Imaging studies of the brain, such as a CT or MRI, are considered definitive in ruling out a brain tumor. The imaging studies take 15 minutes and are easy to order–this is no excuse to avoid such a workup if your child has signs and symptoms of a brain tumor.

The biopsy sample is sent to a lab for testing. Tests can see whether the cells are cancerous or not cancerous. The way the cells look under a microscope can tell your health care team how quickly the cells are growing. This is called the brain tumor's grade.

Can skull base tumors cause seizures? ›

Frequently they present with headaches or other symptoms associated with elevated intracranial pressure, such as nausea or dizziness. Skull base tumors may also cause seizures if they irritate or inflame the adjacent brain tissue.

Excessive bleeding. Hematoma (a pooling of blood in the wound site) Damage to veins, arteries (carotids), nerves (especially those that control vision and eye movements), and other structures in the area. Cerebrospinal fluid (CSF) leaking from the nose.

For patients with malignant tumors, the overall 5-year survival rate for cases with skull base surgery has been reported as 52 to 56%.

Complications following skull base surgery can include intracranial bleeding, blindness, cerebrospinal fluid (CSF) leak, osteonecrosis, cerebral abscess, meningitis, cranial nerve neuropathies, and cosmetic deformity.

The symptoms can develop gradually over some months or even years if the tumour is slow growing. Or quickly over days or weeks if the tumour is fast growing.

Primary tumors most frequently encountered as metastases to the skull include ²: breast cancer. lung cancer. melanoma.

A chordoma is a malignant tumor that can arise from the bones of the skull base. If it is small, it may not cause symptoms. Larger tumors may cause headache and problems with vision, hearing, walking, or balance. These tumors are often slow growing.

You may experience nasal congestion, nausea, headaches, and pain after surgery. However, these symptoms will be managed by medication. If your vital signs (heart rate, breathing rate, blood pressure, and temperature) require closer monitoring, you may spend a night in the intensive care unit (ICU).

Skull base surgery is a specialized type of surgery that focuses on treating conditions at the base of the skull. This includes areas like the undersurface of the brain and important nerves and vessels that exit out of the brain to support senses such as sight, smell, and hearing.

Your surgeon usually makes a small cut on the nasal septum. This is the thin wall of bone and cartilage that separates the nostrils. They put tools through this hole and up to the pituitary gland to remove the tumour. Your surgeon may also use an endoscope.

What does the EEA stand for? ›

EEA stands for European Economic Area. The EEA aims to strengthen trade and economic relations between each of the EEA countries.

You can find more information about the EU on its official website. The United Kingdom left the EEA when it left the EU on 31 January 2020. Iceland, Liechtenstein and Norway are EEA member states, but they are not members of the European Union (EU). Switzerland is not a member of the EU or the EEA.

When we use the expression 'EU/EEA national', we mean a citizen of one of the EU countries or Iceland, Liechtenstein or Switzerland.

The European Free Trade Association (EFTA) is an intergovernmental organisation of Iceland, Liechtenstein, Norway and Switzerland. The European Economic Area (EEA) Agreement is an international agreement enabling among others the extension of parts of the EU's single market to Iceland, Liechtenstein, and Norway.

Norway had considered joining both the EEC and the European Union, but opted to decline following referendums in 1972 and 1994. According to the European Social Survey conducted in 2018, 73.6% of Norwegians would vote 'No' in a Referendum to join the European Union.

EEA seeks to protect, preserve, and enhance the Commonwealth's environmental resources while ensuring a clean energy future for the state's residents.

However, the implementation of the EEA encountered certain challenges including among other resistant to change, poor networking, lack of employment equity awareness, undermining of the HR Officers by Selection Committee members and lack of qualified people with disabilities in certain positions.

As of April 2021, the EEA includes all the EU countries (Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and ...

Endonasal DCR broadly refers to the approach from inside the nose, including the speculum or endoscope view. External DCR involves an incision in the medial canthal or eyelid skin.

Quality of life (QOL) was mapped longitudinally across the first year after endoscopic endonasal resection of 50 anterior skull base meningiomas. At presentation, quality of life was worse in those with larger tumors and visual failure. QOL improved at 6 months and beyond, particularly in those with visual improvement.

What is the coding and reimbursement for endoscopic endonasal surgery of the skull base? ›

What Codes Should I Use for Endoscopic Skull Base Procedures? Currently, only one CPT code exists which describes an endoscopic endonasal approach to a skull base tumor; it is 62165 [ Neuroendoscopy, intracranial; with excision of a pituitary tumor, transnasal or trans-sphenoidal approach ].

Pain: You should expect some nasal and sinus pressure and pain for the first several days after surgery. This may feel like a sinus infection or a dull ache in your sinuses. Extra-strength acetaminophen should relieve mild discomfort. Avoid aspirin and NSAIDs such as ibuprofen or naproxen.

Functional endoscopic sinus surgery (FESS) is minimally invasive surgery for serious sinus conditions. Healthcare providers use nasal endoscopes — thin tubes with lights and lens — to ease your sinus symptoms without making incisions in or around your nose.

Endoscopic spine surgery has a high success rate. An estimated 80 to 90 percent of our patients report less pain and better mobility after surgery.

There are three planes of the body: Coronal (frontal) plane: separates the front (anterior) and back (posterior) of the body. Sagittal (longitudinal) plane: separates the left and right sides of the body. Transverse (axial) plane: separates the upper (superior) and lower (inferior) halves of the body.

Skull-base tumors can be benign (not cancerous) or malignant (cancerous). Because they're located in an area that serves as a relay station for nerves and vessels going to and coming from the brain, even a noncancerous tumor in the skull base can cause symptoms or problems when it grows and affects function.

Skull base surgery can be done in two main ways. Although the preferred method is endoscopic, open surgery is also an option, depending on the type of growth that needs to be removed and its location: Endoscopic or minimally-invasive skull base surgery. This type of surgery usually does not require a large incision.

For patients with malignant tumors, the overall 5-year survival rate for cases with skull base surgery has been reported as 52 to 56%.

A chordoma is a malignant tumor that can arise from the bones of the skull base. If it is small, it may not cause symptoms. Larger tumors may cause headache and problems with vision, hearing, walking, or balance. These tumors are often slow growing.

What type of tumor is skull base? ›

The most common malignant skull base tumors include:

Adenoid cystic carcinoma. Chondrosarcoma. Chordoma. Esthesioneuroblastoma or olfactory neuroblastoma.

Skull base tumors may not produce symptoms until they grow large. Symptoms vary from person to person depending on where the tumor is and how fast it is growing. Skull base tumor symptoms may include: Facial pain or numbness.

Young children's lymph nodes may get bigger when they have a cold or infection and then go back to normal when the child gets better. But if they're bigger than an inch or they grow quickly in clumps, they should be checked by your physician.

A bump on the back of the head has many possible causes, including injuries, cysts, fatty growths, inflamed hair follicles, and bone spurs. Bumps on this part of the body can be hard or soft, and they can vary in size. Injuries are a common cause of bumps and lumps on the back of the head.

Radiotherapy is generally the standard treatment, while some patients with chemosensitive or hormonosensitive lesions benefit from chemotherapy or hormonotherapy and selected patients from surgical removal.