Application of the orbito-cranial approach in pediatric neurosurgery

Vitaly Siomin, Sergey Spektor, Liana Beni-Adani, Shlomi Constantini

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Objective: This study evaluates the benefits of and indications for the orbito-cranial approach (OCA) in pediatric patients. Methods and results: The authors report their recent experience of using the OCA in 9 pediatric patients, 6 boys and 3 girls. The patients' ages ranged from 3 to 17 years (mean 9.6±5.16 years). Follow-up periods varied between 6 and 21 months (mean 12.6±5.9 months). Five patients were operated on for cranio-pharyngiomas, 2 for chiasmatic-hypothalamic astrocytomas, 1 for a recurrent hypothalamic gangliocytoma, and 1 for a hypothalamic hamartoma. In 7 cases a neuronavigation system (BrainLab) was utilized. The lesions were removed totally in 5 patients, near-totally in 1, subtotally in 2, and partially in 1 patient. An average increase of 30% in the area of vertical exposure significantly decreased the need for brain retraction. There was no mortality in this series. The only complications connected with the surgical approach were transient subgaleal cerebro-spinal fluid collections in 7 of 9 children and a subgaleal-peritoneal shunt placement in another patient. Conclusions: Our experience with this series of patients suggests that the OCA is as safe and beneficial in pediatric patients as it is in adults. It facilitates tumor removal by providing shorter access to and better exposure of the suprasellar area, thereby minimizing brain retraction.

Original languageEnglish
Pages (from-to)612-617
Number of pages6
JournalChild's Nervous System
Volume17
Issue number10
DOIs
StatePublished - 1 Jan 2001
Externally publishedYes

Keywords

  • Anterior base of skull
  • Craniopharyngioma
  • Orbito-cranial approach
  • Pediatric
  • Suprasellar tumor
  • Surgery

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