• Emanuele La Corte, Camilla de Laurentis, Francesco Acerbi, Morgan Broggi, Carlotta Pipolo, Alberto Maccari, Giovanni Felisati, and Paolo Ferroli.
• PhD School in Molecular and Translational Medicine, Department of Health Sciences, University of Milan, Milan, Italy; Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. Electronic address: emanuele.lacorte@unimi.it.
• World Neurosurg. 2019 Sep 1; 129: 24-27.

ObjectivePediatric endoscopic endonasal surgery represents a still-growing discipline to approach complex skull base lesions and is characterized by unfavorable anatomical conditions. Children have very small nostrils and narrow rhinosinusal corridors, which could lead more easily to accidental injury to the nasal structures. We describe the use of a peel-away catheter introducer sheath as an innovative and minimally invasive technique to further reduce surgical trauma to the nasal mucosa and structures in pediatric rhinoneurosurgery.MethodsFrom January 2009 to December 2018, the peel-away sheath technique was used in 6 pediatric endoscopic procedures for biopsy and/or removal of skull base tumors.ResultsThe endoscopic technique with the use of the peel-away catheter allowed clear visualization of the surgical field during the whole course of the procedure and good surgical maneuverability. The use of the peel-away sheath did not prolong the surgical operation time and provided a good working channel. No intraoperative or postoperative major complications were observed. No nasal short-term complications were registered in all patients.ConclusionsThe use of a peel-away catheter introducer sheath technique represents a valid adjunct in the endoscopic pediatric skull base surgery repertoire. It can help in avoiding inadvertent surgical traumas to the sinonasal structures, especially by residents and junior surgeons. This could potentially reduce postoperative nasal morbidity.Copyright © 2019 Elsevier Inc. All rights reserved.

17 keywords...

hide…