Pathology along the anterior and posterior skull base has long posed challenges to surgeons due to the difficulty accessing these locations and complexity of the surrounding neurovascular anatomy. Initial surgical management of these disorders included open craniofacial approaches and/or craniotomy and these approaches are still utilized today for selected cases. However, advances in the later half of the 20th century in optics, endoscope design, and high definition digital images allowed the development of microscopic and, more recently, endoscopic approaches to the skull base. This technology was initially developed and used in adults, but has been adapted over time for use in the pediatric patient. In this chapter, the salient points regarding pediatric endoscopic skull base surgery will be reviewed to provide the reader a framework for understanding the indications, pertinent anatomy, preoperative evaluation, and intraoperative management of skull base pathology, highlighting challenges and circumstances unique to the pediatric population.
Part of the book: Endoscopy