Surgical Complications and Management Strategies in Endoscopic Endonasal Transsphenoidal Surgery for Pediatric Craniopharyngiomas

Abstract

Endoscopic endonasal transsphenoidal surgery (EETS) has emerged as an effective method for the resection of craniopharyngiomas in pediatric patients, offering minimally invasive access and enhanced visualization. This literature review examines the surgical complications and management strategies associated with EETS for pediatric craniopharyngiomas. Common complications include cerebrospinal fluid (CSF) leaks, intraoperative hemorrhage, hypopituitarism, and visual disturbances. The incidence of these complications is influenced by factors such as tumor size and location, patient age, comorbidities, and surgeon experience. Effective management strategies involve meticulous preoperative planning, advanced imaging techniques, intraoperative monitoring, and comprehensive postoperative care. Detailed preoperative imaging is crucial for surgical planning, while intraoperative neuronavigation and neurophysiological monitoring help mitigate risks. Postoperative care, including endocrine evaluation and rehabilitation, is essential for addressing complications and improving patient outcomes. This review underscores the critical aspects of managing surgical complications to enhance the safety and efficacy of EETS in treating pediatric craniopharyngiomas.