Summary
The techniques of skull base surgery attempt to maximize the exposure of a cranial base lesion while using the least amount of brain retraction. Cranial base surgery is not a ‘new’ area of neurosurgical or otolaryngologic interest, but instead represents a resurgence of efforts to treat difficult lesions involving the cranial base. This resurgence of interest and effort is a product of recent advances in microanatomical knowledge of the cranial base, advances in microsurgical technique, improved neurophysiologic monitoring, and improved collaborative relationships between neurosurgery, otolaryngology and plastic surgery. Furthermore, improved neuroanesthetic techniques allow the surgeon to proceed with surgery without undue concern about time, and improved neuroimaging techniques provide the surgeon with detailed knowledge of the three dimensional characteristics of the tumor and surrounding structures [1].
This review will focus on the surgical management of cranial base tumors primarily affecting the pediatric population.
Little has been written on the techniques of skull base surgery as they apply to the pediatric population, since cranially-based tumors are a relatively rare occurrence in this patient population. In most instances, however, many of the 'standard' skull base approaches can be applied to the pediatric patient with few modifications, and in our experience, the pediatric patients have tolerated these approaches as well as their adult counterparts.
Similar content being viewed by others
References
Sekhar LN, Goel A: General considerations. In: Apuzzo MLJ (ed) Brain Surgery: Complication Avoidance and Management. Churchill Livingstone 2167–2174, 1993
Sekhar LN, Pomeranz S, Sen CN: Management of tumours involving the cavernous sinus. Acta Neurochir Suppl 53: 101–112, 1991
Hirsch WLJ, Hryshko FG, Sekhar LN, Brunberg J: Comparison of MR imaging, CT and angiography in the evaluation of the enlarged cavernous sinus. AJR 151: 1015–1023, 1988
Erba SM, Horton JA, Latchaw RE, Yonas H, Sekhar LN, Schramm V, Pentheny S: Balloon test occlusion of the internal carotid artery with stable xenon/CT cerebral blood flow imaging. AJNR 9: 533–538, 1988
Sekhar LN, Pomeranz S, Sen CN: Extradural petrous bone and petroclival neoplasms. Acta Neurochir Suppl 53: 183–192, 1991
Al-Mefty O, Ayoubi S, Smith RR: The petrosal approach: indications, techniques, and results. Acta Neurochir Suppl 53: 166–170, 1991
Sekhar LN, Sen CN: An extended frontal approach to tumors involving the skull base. In: Wilkins RH, Rengachary SS (eds) Neurosurgery Update I: Diagnosis, Operative Technique, and Neuro-Oncology. McGraw-Hill, Inc. 292–301, 1990
Sekhar LN, Nanda A, Sen CN, Snyderman CN, Janecka IP: The extended frontal approach to tumors of the anterior, middle, and posterior skull base. J Neurosurg 76: 198–206, 1992
Haines SJ, Marentette LJ, Wirtschafter JD: Extended fronto-orbital approaches to the anterior cranial base: variations on a theme. Skull Base Surgery 2: 134–141, 1992
Long DM: Surgical approaches to tumors of the skull base: an overview. In: Wilkins RH, Rengachary SS (eds) Neurosurgery Update I: Diagnosis, Operative Technique, and Neuro-Oncology. McGraw-Hill, Inc. 266–276, 1990
Janecka IP, Sen CN, Sekhar LN, Arriaga M: Facial translocation: a new approach to the cranial base. Otolaryngol Head Neck Surg 103: 413, 1990
Jackson I: Craniofacial osteotomies to facilitate the resection of tumors of the skull base. In: Wilkins R, Rengachary S (eds) Neurosurgery Update I: Diagnosis, Operative Technique, and Neuro-Oncology. McGraw-Hill, Inc. 277–291, 1990
Sekhar LN, Sen CN, Jho HD: Saphenous vein graft bypass of the cavernous internal carotid artery. J Neurosurg 72: 35–41, 1990
Al-Mefty O: Surgical exposure of petroclival tumors. In: Wilkins RH, Rengachary SS (eds) Neurosurgery Update I: Diagnosis, Operative Technique, and Neuro-Oncology, McGraw-Hill, Inc. 409–414, 1990
Papel ID, Kennedy DW, Cohn E: Sublabial transseptal transsphenoidal approach to the skull base. ENT 65: 20, 1986
Kennedy DW, Papel ID, Holliday M: Transpalatal approach to the skull base. ENT 65: 48, 1986
Biller HF, Lawson W: Anterior mandibular-splitting approach to the skull base. ENT 65: 61, 1986
Koch WM, Price JC: Midface degloving approach to tumors involving the skull base. In: Wilkins RH, Rengachary SS (eds) Neurosurgery Update I: Diagnosis, Operative Technique, and Neuro-Oncology. McGraw-Hill, Inc. 302–305, 1990
Price JC: The midfacial degloving approach to the central skullbase. ENT 65: 174–180, 1986
Rubenfeld M, Wirtschafter J: Management of ophthalmic complications in surgery of the brainstem. Neurosurgery Clinics of North America 4: 581–591, 1993
Marentette L, Goding G, Levine S: Rehabilitation of the lower cranial nerves. Neurosurgery Clinics of North America 4: 573–580, 1993
Haines S, Duvall A: Transzygomatic and transpalatal excision of juvenile nasopharyngeal angiofibroma with intra-cranial extension. In: Sekhar L, Janecka I (eds) Surgery of Cranial Base Tumors. Raven Press, Ltd., New York 477–484, 1993
Economou TS, Abemayor E, Ward PH: Juvenile nasopharyngeal angiofibroma: an update of the UCLA experience, 1960–1985. Laryngoscope 98: 170–175, 1988
Andrews JC, Fisch F, Valavanis A, Aeppli U, Makek MS: The surgical management of extensive nasopharyngeal angiofibromas with the infratemporal fossa approach. Laryngoscope 99: 429–437, 1989
Jafek BW, Krekorian EA, Kirsch WM, Wood RP: Juvenile nasopharyngeal angiofibroma: management of intracranial extension. Head Neck Surg 2: 119–128, 1979
Farag MM, Ghanamch SE, Raggaie A: Hormone receptors in juvenile nasopharyngeal angiofibroma. Laryngoscope 97: 208–211, 1987
Martin H, Ehrlich HE, Abels JC: Juvenile nasopharyngeal angiofibroma. Am Surg 129: 513–536, 1948
Harms RA: Nasopharyngeal angiofibroma. Acta Otolaryngol Suppl 146: 1–76, 1958
Grossman CB: Magnetic resonance imaging and computed tomography of the head and spine. Williams and Wilkins, Baltimore 338–343, 1990
Deutsch M: Radiation therapy in the treatment of tumors of the cranial base. In: Sekhar LN, Schramm VL (eds) Tumors of the Cranial Base: Diagnosis and Treatment. Futura Publishing Co., Inc., New York 163–190, 1987
Cummings BJ: Relative risk factors in the treatment of juvenile nasopharyngeal angiofibroma. Head Neck Surg 3: 21–26, 1980
Cummings BJ, Blend R, Keane T,et al.: Primary radiation therapy for juvenile nasopharyngeal angiofibroma. Laryngoscope 94: 1599–1605, 1984
Goepfert H, Cangir A, Lee Y: Chemotherapy for aggressive juvenile nasopharyngeal angiofibroma. Arch Otolaryngol 111: 285–289, 1985
Heffelfinger MJ, Dahlin DC, McCarty CS,et al.: Chordomas and cartilaginous tumors at the skull base. Cancer 32: 410–420, 1973
Keisch ME, Garcia DM, Shibuya RB: Retrospective long-term follow-up analysis in 21 patients with chordomas of various sites treated at a single institution. J Neurosurg 75: 374–377, 1991
Dahlin DC: Bone Tumors: General Aspects and Data on 6221 Cases. Charles C. Thomas, Springfield, Ill. 329–343, 1978
Spjut HJ, Dorfman HD, Fechner RE,et al.: Tumors of Bone and Cartilage. Atlas of Tumor Pathology, Second Series Fascicle 5, Armed Forces Institute of Pathology, Washington, D.C. 20–21, 1971
Evans HL, Ayala AG, Romsdahl MM: Prognostic factors in chondrosarcoma of bone. Cancer 40: 818–831, 1977
Wold LE, Laws ER: Cranial chordomas in children and young adults. J Neurosurg 59: 1043–1047, 1983
Sen CN, Sekhar LN, Schramm VL, Janecka IP: Chordoma and chondrosarcoma of the cranial base: an 8-year experience. Neurosurgery 25: 931–941, 1989
Rich TA, Schiller A, Suit HD, Mankin HJ: Clinical and pathological review of 48 cases of chordoma. Cancer 56: 182–187, 1985
Higinbotham NL, Phillips RF, Farr HW,et al.: Chordoma: Thirty-five year study at Memorial Hospital. Cancer 20: 1841–1850, 1967
Devita VT: Cancer. Principles and Practice of Oncology. J.B. Lippincott, Philadelphia 1334, 1985
Moore KL: The Developing Human. Clinically Oriented Embryology. W.B. Saunders, Philadelphia 57, 1982
Chambers PW, Schwinn CP: Chordoma. A clinicopathologic study of metastasis. Am J Clin Pathol 72: 765–776, 1979
Grossman RI, Davis KR: Cranial computed tomographic appearance of chondrosarcoma of the base of the skull. Radiology 141: 403–408, 1981
Meyer JE, Oot RF, Lindfors KK: CT appearance of clival chordomas. J Comput Assist Tomogr 10: 34–38, 1986
Grossman CB: Magnetic Resonance Imaging and Computed Tomography of the Head and Spine. Williams and Wilkins, Baltimore 275, 1990
Raffel C, Wright DC, Gutin PH, Wilson CB: Cranial chordomas. Clinical presentation and results of operative and radiation therapy in twenty-six patients. Neurosurgery 17: 703–710, 1985
Pearlman AW, Friedman M: Radical radiation therapy of chordoma. AJR 108: 333–341, 1970
Cummings BJ, Hodson DI, Rush RS: Chordoma: The results of megavoltage radiation therapy. Int J Radiat Oncol Biol Phys 9: 633–642, 1983
Saxton JP: Chordoma. Int J Radiol Oncol Biol Phys 7: 913–915, 1981
Austin-Seymour M, Munzenrider J, Goitein M,et al.: Fractionated proton radiation therapy of chordoma and low-grade chondrosarcoma of the base of the skull. J Neurosurg 70: 13–17, 1989
Berson AM, Castro JR, Petti P,et al.: Charged particle irradiation of chordoma and chondrosarcoma of the base of the skull and cervical spine. The Lawrence Berkeley laboratory experience. Int J Radiat Oncol Biol Phys 15: 559–565, 1988
Kondziolka D, Lunsford LD, Flinkinger JC: The role of radiosurgery in the management of chordoma and chondrosarcoma of the cranial base. Neurosurgery 29: 38–416, 1991
Gutin PH, Leibel SA, Hosobuchi Y, Crumley RL, Edwards MSB, Wilson CB, Lamb S, Weaver KA: Brachytherapy of recurrent tumors of the skull base and spine with iodine-125 sources. Neurosurgery 20: 938–945, 1987
de Champs C, Demeocq F, Merle P, Palcoux JB, Morh M, Hartmann O: Neuroblastome olfactif revele par une cecite chez une fillette de 9 mois. Arch Fr Pediatr 42: 119–121, 1985
Tyler TC, Chandler JR, Wetli C,et al.: Olfactory neuroblastoma. South Med J 67: 640–643, 1974
Elkon D, Hightower SI, Lim ML,et al.: Esthesioneuroblastoma. Cancer 44: 1087–1094, 1979
Meneses MS, Thurel C, Mikol J, Ramina R, Maniglia JJ, Arruda WO, Cophignon J: Esthesioneuroblastoma with intracranial extension. Neurosurgery 27: 813–820, 1990
Fahlbusch R, Neubauer U, Wigand M, Weidenbecher M, Rockelein G, Thierauf P, Sauer R: Neurorhinosurgical treatment of aesthesioneuroblastoma. Acta Neurochir (Wien) 100: 93–100, 1989
Bailey BJ, Barton SB: Olfactory neuroblastoma: management and prognosis. Arch Otolaryngol 101: 1–5, 1975
Shah JP, Feghali J: Esthesioneuroblastoma. Am J Surg 142: 456–458, 1981
Kadish S, Goodman M, Wang CC: Olfactory neuroblastoma: a clinical analysis of 17 cases. Cancer 37: 1571–1576, 1976
Spaulding CA, Kranyak MS, Constable WC, Stewart FM: Esthesioneuroblastoma: a comparison of two treatment eras. Int J Rad Oncol Biol Phys 15: 581–590, 1988
Olsen KD, DeSanto LW: Olfactory neuroblastoma: biologic and clinical behavior. Arch Otolaryngol 109: 797–802, 1983
Takahashi H, Wakabayashi K, Ikuta F, Tanimura K: Esthesioneuroblastoma: a nasal catecholamine-producing tumor of neural crest origin. Acta Neuropathol 76: 522–527, 1988
Rakes SM, Yeatts RP, Campbell RJ: Ophthalmic manifestations of esthesioneuroblastoma. Ophthalmology 92: 1749–1753, 1985
Ogura JH, Schenck NL: Unusual nasal tumors: problems in diagnosis and treatment. Otolaryngol Clin North Am 6: 813–817, 1973
Lochrin C: Esthesioneuroblastoma. Med Ped Oncol 17: 433–438, 1989
Castaneda VL, Cheah MSC, Saldivar VA, Richmond CM, Parmley RT: Cytogenetic and molecular evaluation of clinically aggressive esthesioneuroblastoma. Am J Ped Hem/Oncol 13: 62–70, 1991
Grossman CB: Magnetic Resonance Imaging and Computed Tomography of the Head and Spine. Williams and Wilkins, Baltimore 342, 1990
Biller HF, Lawson W, Sachdev VP, Som P: Esthesioneuroblastoma: surgical treatment without radiation. Laryngoscope 100: 1199–1201, 1990
Mack EE, Prados MD, Wilson CB: Late manifestations of esthesioneuroblastoma in the central nervous system: report of two cases. Neurosurgery 30: 93–97, 1991
Cantrell RW, Ghorayeb BY, Fitz-Hugh GS: Esthesioneuroblastoma diagnosis and treatment. Ann Otol Rhinol Laryngol 86: 760–765, 1977
Newbill ET, Johns ME, Cantrell RW: Esthesioneuroblastoma: diagnosis and management. South Med J 78: 275–282, 1985
Wade PM, Smith RE, Johns ME: Response of esthesioneuroblastoma to chemotherapy: report of five cases and review of the literature. Cancer 53: 1036–1041, 1984
Goldsweig HG, Sundaresan N: Chemotherapy of recurrent esthesioneuroblastoma: case report and review of the literature. Am J Clin Oncol 13: 139–143, 1990
Heros DO, Hochberg FH: Treatment of esthesioneuroblastoma with chemotherapy: a report of two cases. J Neuro-Onc 6: 141–145, 1988
Stewart FM, Lazarus HM, Levine PA, Stewart KA, Tabbara IA, Spaulding CA: High-dose chemotherapy and autologous transplantation for esthesioneuroblastoma and sinonasal undifferentiated carcinoma. Am J Clin Oncol (CCT) 12: 217–221, 1989
Polonowski JM, Braasnu D, Roux FX, Bassot V: Esthesioneuroblastoma. Complete tumor response after induction chemotherapy. Ear, Nose and Throat J 69: 743–746, 1990
Mills SE, Frierson HF: Olfactory neuroblastoma -a clinicopathologic study of 21 cases. Am J Surg Pathol 9: 317–327, 1985
Drake JM, Hendrick EB, Becker LE, Chuang SH, Hoffman HJ, Humphreys RP: Intracranial meningiomas in children. Pediat Neurosci 12: 134–139, 1985
Chan RC, Thompson GB: Intracranial meningiomas in childhood. Surg Neurol 211: 319–322, 1984
Rohringer M, Sutherland GR, Louw DF, Sima AF: Incidence and clinicopathological features of meningiomas. J Neurosurg 71: 665–672, 1989
Rachlin JR, Rosenblum ML: Etiology and biology of meningiomas. In: Al-Mefty O (ed) Meningiomas. Raven Press, Ltd., New York 22–37, 1991
Doty JR, Schut L, Bruce DA, Sutton LN: Intracranial meningiomas of childhood and adolescence. Prog Exp Tumor Res 30: 247–254, 1987
Drake JM, Hoffman HJ: Meningiomas in children. In: Al-Mefty O (ed) Meningiomas. Raven Press, Ltd., New York 145–152, 1991
Kallio M, Sankila R, Hakulinen T, Jaaskelainen J: Factors affecting operative and excess long-term mortality in 935 patients with intracranial meningioma. Neurosurgery 31: 2–12, 1992
Russell DS, Rubenstein LF: Pathology of Tumors of the Nervous System. Williams and Wilkins, Baltimore, 1982
Kepes JJ: Meningiomas: Biology, Pathology and Differential Diagnosis. Masson, New York, 1982
Perilongo G, Sutton LN, Goldwein JW, Gusnard D, Schut L, Biegel JA, Rorke LB, Lange B, D'Angio GJ: Childhood meningiomas. Experience in the modern imaging era. Pediatr Neurosurg 18: 16–23, 1992
Chadduck WM, Boop FA, Blankenship JB, Husain M: Meningioma and sagittal craniosynostosis in an infant: case report. Neurosurgery 30: 441–442, 1992
Niida H, Tanaka R, Takeda N, Tacheuchi S, Hinokuma K, Takahashi H: Meningioma in a neonate: case report. Surg Neurol 38: 273–276, 1992
Collins VP, Mordenskjold M, Dumanski JP: The molecular genetics of meningioma. Brain Pathology 1: 19–24, 1990
Annegers JF, Laws ERJ, Kurland LT, Grabow JD: Head trauma and subsequent brain tumors. Neurosurgery 4: 203–206, 1979
Choi NW, Schuman LM, Gullen WH: Epidemiology of primary central nervous system neoplasms. II. Case control study. Am J Epidemiol 91: 467–485, 1970
Sano K, Wakai S, Ochiai C: Characteristics of meningiomas in childhood. Child's Brain 8: 98–106, 1981
Merten DF, Gooding CA, Newton TH: Meningiomas of childhood and adolescence. J Pediat 84: 696–700, 1974
Vassilouthis J, Ambrose JAE: Intraventricular meningioma in a child. Surg Neurol 10: 105–107, 1978
Crouse SK, Berg BO: Intracranial meningiomas in childhood and adolescence. Neurology 22: 135–141, 1972
Celli P, Palma L, Domenicucci M, Scarpinati M: Histologically benign recurrent meningioma metastasizing to the parotid gland: case report and review of the literature. Neurosurgery 31: 1113–1116, 1992
Russell DS, Rubenstein LF: Pathology of Tumors of the Nervous System. Williams and Wilkins, Baltimore, 1982
Kepes JJ: Meningiomas: Biology, Pathology and Differential Diagnosis. Masson, New York 190, 1982
Davidson GS, Hope JK: Meningeal tumors of childhood. Cancer 63: 1205–1210, 1989
O'Rahilly R, Miller F: The meninges in human development. Neuropathol Exp Neurol 45: 588–608, 1986
Zulch KJ: Brain Tumors: The Biology and Pathology. Springer-Verlag, New York, 1986
Chou SN, Miles JM: The pathology of meningiomas. In: Al-Mefty O (ed) Meningiomas. Raven, New York 35–59, 1991
Russell DS, Rubenstein LF: Pathology of Tumors of the Nervous System. Williams & Wilkins, Baltimore, 1982
Fortuna A, Ferrante L, Acqui M, Guglielmi G, Mastronard L: Cystic meningiomas. Acta Neurochir (Wien) 90: 23–30, 1988
Deen HGJ, Scheithauer BW, Ebersold MJ: Clinical and pathological study of meningiomas in the first two decades of life. J Neurosurg 56: 317–322, 1982
Ludwin SK, Rubenstein LJ, Russell DS: Papillary meningioma: a malignant variant of meningioma. Cancer 36: 1363–1373, 1975
Zulch KJ: Brain Tumors: The Biology and Pathology. Springer-Verlag, New York, 1986
Fukui M, Iwaki T, Sawa H, Inoue T, Takeshita I, Kitamura K: Proliferative activity of meningiomas as evaluated by bromodeoxyuridine uptake examination. Acta Neurochir (Wien) 81: 135–141, 1986
Spaar FW, Ahyai A, Blech M: DNA-fluorescence-cytometry and prognosis (grading) of meningiomas — a study of 104 surgically removed tumors. Neurosurg Rev 10: 35–39, 1987
Zankl H, Zang KD: Correlations between clinical and cutogenetical data in 180 human meningiomas. Cancer Genet Cytogenet 1: 351–356, 1980
Magdelenat H, Pertuiset BF, Poisson M, Martin PM, Phillippon J, Pertuiset B, Buge A: Progestin and estrogen receptors in meningiomas. Biochemical characterization, clinical and pathological correlations in 42 cases. Acta Neurochir (Wien) 64: 199–213, 1982
Martuza RL, Miller DC, MacLaughlin DT: Estrogen and progestin binding by cytosolic and nuclear fractions of human meningiomas. J Neurosurg 62: 750–756, 1985
Higer HP, Pedrosa P, Schuth M: MR imaging of cerebral tumors: State of the art and work in progress. Neurosurg Rev 12: 91–106, 1989
Jacob JM, Hamsberger HR: Diagnostic angiography and meningiomas. In: Al-Mefty O (ed) Meningiomas. Raven Press, New York 225–241, 1991
Nakasu S, Hirano A, Llena JF, Shimura T, Handa J: Interface between the meningioma and the brain. Surg Neurol 32: 206–212, 1989
Shapir J, Cobleutz C, Malanson D, Ethier R, Robilanille Y: New CT findings in aggressive meningiomas. AJNR 6: 101–102, 1985
DiChiro G, Hatazawa J, Katz DA, Rizzoli HV, DeMichele DJ: Glucose utilization by intracranial meningiomas as an index of tumor aggressiveness and probability of recurrence. Radiology 164: 521–526, 1987
Wirth FP, Downing EF, Cannon CLJ, Baker RP: Experience with the neodymium: yttrium-aluminium-garnet laser in forty-two cases. Neurosurgery 21: 867–871, 1987
Oka K, Tsuda H, Kamikaseda K, Nakamura R, Fukui M, Nouzuka Y, Sveishi K: Meningiomas and hemorrhagic diathesis. J Neurosurg 62: 750–756, 1985
Sawaya R, Raimo OJ: Systemic and thromboembolic effects of meningiomas. In: Al-Mefty O (ed) Meningiomas. Raven Press, New York 117–135, 1991
Barbaro NM, Gutin PH, Wilson CB, Sheline GE, Boldrey EB, Wara WM: Radiation therapy in the treatment of partially resected meningiomas. Neurosurgery 20: 525–528, 1987
Mesic JB, Hanks GE, Doggett RL: The value of radiation therapy as an adjuvant to surgery in intracranial meningiomas. Am J Clin Oncol 9: 337–340, 1986
Oi S, Kokunai T, Ijichi A, Matsumoto S, Raimondi AJ: Radiation-induced brain damage in children. Neurol Med Chir (Tokyo) 30: 36–42, 1990
Spunberg JJ, Chang CH, Goldman M, Auricchio E, Bell JJ: Quality of long-term survival following irradiation for intracranial tumors in children under the age of two. Int J Radiat Oncol Biol Phys 7: 727–736, 1981
Grunberg SM, Weiss MH, Spitz IM, Ahmadi J, Saduca A, Russell C, Lucci L, Stevenson L: Treatment of unresectable meningiomas with the antiprogesterone agent mife-pristone. J Neurosurg 74: 861–866, 1991
Jaaskelainen J, Laasonen E, Karkkainen J, Haltia M, Troupp H: Hormone treatment of meningiomas: Lack of response to medroxyprogesterone acetate (MPA). A pilot study of five cases. Acta Neurochir (Wien) 80: 35–41, 1986
Russell DS, Rubenstein LJ: Pathology of Tumors of the Nervous System. Williams & Wilkins, Baltimore, 1982
Zulch K: Brain Tumors. Their Biology and Pathology. Springer-Verlag, New York, 1986
Tomita T, McLone DG: Radical resections of childhood craniopharyngiomas. Pediatr Neurosurg 19: 6–14, 1993
Symon L, Pell MF, Habib AHA: Radical excision of craniopharyngioma by the temporal route: a review of 50 patients. Br J Neurosurg 5: 539–549, 1991
Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P: Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg 73: 3–11, 1990
Zulch KJ: Brain Tumors: Their Biology and Pathology. Springer-Verlag, New York, 1986
Byrne MN, Sessions DG: Nasopharyngeal craniopharyngioma. Case report and literature review. Ann Otol Rhinol Laryngol 99: 633–639, 1990
Young SC, Zimmerman RA, Nowell MA, Bilaniuk LT, Hackney DB, Grossman RI, Goldberg HI: Giant cystic craniopharyngioma. Neuroradiology 29: 468–473, 1987
Gokalp HZ, Egemen N, Ildan F, Bancaa K: Craniopharyngioma of the posterior fossa. Neurosurgery 29: 446–448, 1991
Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI: Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 76: 47–52, 1992
Wen DY, Seljeskog EL, Haines SJ: Microsurgical management of craniopharyngiomas. Br J Neurosurg 6: 467–474, 1992
Landolt AM, Zachmann M: Results of transsphenoidal extirpation of craniopharyngiomas and Rathke's cysts. Neurosurgery 28: 410–415, 1991
Okazaki H: Fundamentals of Neuropathology. Morphologic Basis of Neurologic Disorders, Igaku-Shoin, NewYork 258, 1989
Adamson TE, Wiestier OD, Kleihues P, Yasargil MG: Correlation of clinical and pathological features in surgically treated craniohparyngiomas. J Neurosurg 73: 12–17, 1990
Okazaki H: Fundamentals of Neuropathology. Morphologic Basis of Neurologic Disorders, Igaku-Shoin, NewYork 257, 1989
Grossman CB: Magnetic Resonance Imaging and Computed Tomography of the Head and Spine. Williams & Wilkins, Baltimore 269–270, 1990
Pusey E, Kortman KE, Flanningan BD, Tsuruda J, Bradley WG: MR of craniopharyngiomas, tumor delineation and characterization. AJR 149: 383–388, 1987
Karnaze MG, Sartor K, Winthrop JD: Suprasellar lesions: Evaluation with MR imaging. Radiology 161: 77–82, 1986
Regine WF, Kramer S: Pediatric craniopharyngiomas: long term results of combined treatment with surgery and radiation. Int J Radiat Oncol Biol Phys 24: 611–617, 1992
Fischer EG, Welch K, Shillito J, Winston KR, Tarbeil NJ: Craniopharyngiomas in children. Long-term effects of conservative surgical procedures combined with radiation therapy. J Neurosurg 73: 534–540, 1990
Baskin DS, Wilson CB: Surgical management of craniopharyngiomas. J Neurosurg 65: 22–27, 1986
Ammirati M, Samii M, Sephernia A: Surgery of large retrochiasmatic craniopharyngiomas in children. Child's Nerv Syst 6: 13–17, 1990
Al-Mefty O, Hassounah M, Weaver P, Sakati N, Jinkins JR, Fox JL: Microsurgery for giant craniopharyngiomas in children. Neurosurgery 17: 585–595, 1985
Sung DI, Chang CH, Harisiadis L, Carmel PW: Treatment results of craniopharyngiomas. Cancer 47: 847–852, 1981
Hoff JT, Patterson RH: Craniopharyngiomas in children and adults. J Neurosurg 36: 299–302, 1972
Tomita T: Management of craniopharyngioma in children. Pediatr Neurosci 14: 204–211, 1988
Nelson GA, Bastian FO, Schlitt M, White RL: Malignant transformation in craniopharyngioma. Neurosurgery 22: 427–429, 1988
Vyramuthu N, Benton TF: The management of craniopharyngiomas. Clin Radiol 34: 629–632, 1983
Ragoowansi AT, Piepgras DG: Postoperative ectopic craniopharyngioma. Case report. J Neurosurg 74: 653–655, 1991
Hoffman HJ, Hendrick EB, Humphreys RP, Buncic JR, Armstrong DL, Jenkin RD: Management of craniopharyngioma in children. J Neurosurg 47: 218–227, 1977
Cavazzuti V, Fischer EG, Welch K, Belli JA, Wiston KR: Neurological and psychophysiological sequelae following different treatment of craniopharyngioma in children. J Neurosurg 59: 409–417, 1983
Shapiro K, Till K, Norman D: Craniopharyngiomas in childhood. A rational approach to treatment. J Neurosurg 50: 617–623, 1979
Amacher L: Craniopharyngioma; the controversy regarding radiotherapy. Childs Brain 6: 57–64, 1980
Honegger J, Buchfelder M, Fahlbusch R, Daubler B, Dorr HG: Transsphenoidal microsurgery for craniopharyngioma. Surg Neurol 37: 189–196, 1992
Laws ER Jr: Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurgery 52: 661–666, 1980
Ackland FM, Stanhope R, Preece MA: Cushing's disease and craniopharyngioma. Arch Dis Child 62: 1077–1078, 1987
Sutton LN, Gusnard D, Bruce DA, Fried A, Packer RJ, Zimmerman RA: Fusiform dilatations of the carotid artery following radical surgery of childhood craniopharyngiomas. J Neurosurg 74: 695–700, 1991
Okazaki H: Fundamentals of Neuropathology. Morphologic Basis of Neurologic Disorders, Igaku-Shoin, NewYork 23, 1989
Allcut DA, Hoffman HJ, Isla A, Becker LE, Humphreys RP: Acoustic schwannomas in children. Neurosurgery 29: 14–18, 1991
Hernanz-Schulman M, Welsh K, Strand R, Ordia JI: Acoustic neuromas in children. AJNR 7: 519–521, 1986
Laha RK, Huestis WS: Unilateral acoustic neuroma and cerebello-pontine angle lesions in children. Surg Neurol 4: 371–374, 1975
Mattucci KF, Glass WM, Setzen M, Levin W: Childhood acoustic neuroma. NY State Med 87: 665–666, 1987
Rushworth RG, Sorby WA, Smith SF: Acoustic neuroma in a child treated with the aid of preoperative arterial embolization. J Neurosurg 61: 396–398, 1984
Vassilouthis J, Richardson AE: Acoustic neurinoma in a child. Surg Neurol 12: 37–39, 1979
Fabiani A, Croveri G, Torta A: Neurinoma de la fossa posteriore in un bambino di un anno. Acta Neurol (Napoli) 30: 218–222, 1975
Mapstone TB: Neurofibromatosis and central nervous system tumors in childhood. In: Anonymous (ed) Pediatric Neuro-Oncology. Neurosurgery Clinics of North America 771–779, 1992
Martuza RL, Eldridge R: Neurofibromatosis 2. N Engl J Med 318: 684–688, 1988
Grossman CB: Magnetic Resonance Imaging and Computed Tomography of the Head and Spine. Williams & Wilkins, Baltimore 296, 1990
Albright AL: Posterior fossa tumors. In: Pediatric Neuro-Oncology. Neurosurgery Clinics of North America 881–891, 1992
Cohen BH, Kaplan AM, Packer RJ: Management of intracranial neoplasms in children with neurofibromatosis type 1 and 2. Pediatr Neurosurg 16: 66–72, 1990
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kennedy, J.D., Haines, S.J. Review of skull base surgery approaches: With special reference to pediatric patients. J Neuro-Oncol 20, 291–312 (1994). https://doi.org/10.1007/BF01053045
Issue Date:
DOI: https://doi.org/10.1007/BF01053045