Surgical planning in pediatric skull base surgery

Treatment of pediatric skull base disorders is complex and requires individual planning. Compared to adult patients, the pathologies are more congenital and benign. Advanced surgical planning has been shown to improve outcomes and involves a variety of different software platforms to enable sophisticated review of image data sets, including virtual endoscopy and the details of surgical approach options. There are greater than 50 open and endoscopic surgical approaches described. Endoscopic approaches in patients under age 4 are extremely challenging due to the underdeveloped sinuses and overall smaller size of the craniofacial skeleton and nasal cavity. A multidisciplinary surgical team should develop and review surgical plan options with the patient and family.