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North American Skull Base Society

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2025 Poster Presentations

2025 Poster Presentations

 

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P200: ETIOLOGY AND MANAGEMENT OF RECURRENT HEMIFACIAL SPASM - A SINGLE-CENTER EXPERIENCE
Mariam A Al Mutawa, MD1; Werner Hosemann2; Chia Jung-Busch, MD3; Henry W Schroeder1; 1Department of Neurosurgery, University Medicine Greifswald; 2ENT Department, Klinikum Stralsund; 3ENT Department, University Medicine Greifswald

Objective: To demonstrate the surgical techniques for endoscopic endonasal approach in paediatric patients.

Methods: Three interesting cases of skullbase lesions will be presented focussing on the surgical technique.

Results: 1. A 12-year-old girl presented with growth arrest, cushingoid appearance, and metabolic syndrome with high cortisol levels. MRI showed a pituitary adenoma which extends through the hiatus of the diaphragm into the suprasellar area. An endonasal gross total resection was done. After 10 months follow-up the patient’s cortisol level normalized, and 2 cm growth was noticed.

2.  A 6-year-old boy presented with an incidental finding of a clival chordoma after fall without neurological deficits. MRI showed a chordoma of the lower clivus. An endoscopic endonasal resection with partial removal of the odontoid was performed, followed by C1/C2 fixation. Postoperative MR imaging showed gross total tumor resection. The boy was doing well after surgery with no neurological deficits. Three months after surgery he underwent proton beam radiation. Three years after surgery, he is doing well without recurrence.

3. A 2.5-year-old boy presented with bilateral abducens paly. MRI showed a large clival chordoma. Although very young, an endonasal gross total resection was possible. Five months after surgery he underwent proton beam radiation. Abducens palsy improved on both sides after 2 years. Seven years after surgery he is well without signs of recurrence.

Conclusion: Endoscopic endonasal approaches are feasible in the paediatric population in well selected patients.

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