Comparative analysis of long-term results of surgical treatment of children with basal encephaloceles

Abstract

Basal encephaloceles (skull base hernias) are a rare pathology manifested by prolapse of altered membranes and brain tissue through a bone defect of the skull base. Endoscopic access is safer and is currently used as the method of choice in the treatment of this pathology. Available literature studies do not cover the quality of life of these patients at follow-up. There is a controversy regarding the impact of endoscopic access on the growth centers of the facial skeleton. Material and methods. A retrospective analysis of a series of 100 patients aged 0 to 18 years with basal encephaloceles who underwent surgical treatment at the N. N. Burdenko National Medical Research Center of Neurosurgery from 2005 to 2022 was carried out to determine the effectiveness and safety of the endoscopic method in the treatment of patients with basal encephaloceles and identify factors affecting the quality of life of these patients. Results and conclusions. Endoscopic endonasal access in the treatment of children with basal encephaloceles is effective and safe. Patients have a high quality of life (>85 points) at follow-up. After the operation, there is an improvement in nasal breathing and an increase in the degree of psychomotor development. Patients have a high quality of life (>85 points) at follow-up. A lower quality of life at follow-up was observed in children with delayed psychomotor development before surgery (OR=0.6; p=0.003). The follow-up study of the dynamics of craniometric parameters did not reliably show any disturbances in the growth of the bones of the facial skeleton in patients after endoscopic surgery.