Pediatric Endoscopic Endonasal Skull Base Surgery Program Offers State of the Art Treatment Options for Children

August 21, 2018

Pediatric endoscopic endonasal surgery was pioneered in adult hospitals. At Lurie Children’s, Jeffrey Rastatter, MD, pediatric otolaryngologist and Tord Alden, MD​, pediatric neurosurgeon recognized the value of having this type of dedicated program at a children’s hospital.

“Here we focus solely on children, and as pediatric specialists we are used to dealing with the smaller surgical fields and age specific nuances of the pediatric skull base,” said Dr. Rastatter. “In addition, children’s hospitals provide unique services and resources that help reduce anxiety and allow children to feel safe and secure.”

Endoscopic endonasal surgery is a minimally invasive technique that uses an endoscope introduced through the nose to provide access to the midline cranial base, allowing for surgical intervention for a variety of lesions and pathologies. Some of the conditions we treat include pituitary tumors, craniopharyngiomas, juvenile nasopharyngeal angiofibroma (JNA), and other benign or malignant cranial base lesions.

Initially launched in 2010 by Drs. Rastatter and Alden, the Endonasal Skull Base Surgery program has grown into a fully comprehensive, multidisciplinary program which also includes radiology, oncology, endocrinology, pathology and social work. Lurie Children’s is the only pediatric hospital in the Chicagoland area with a dedicated multidisciplinary program focused solely on evaluation and treatment of pediatric patients with such skull base lesions. In fact, this is one of a very few dedicated pediatric programs throughout the United States and beyond.


Surgical intervention is needed when a condition such as a large chordoma is present. In this case, the chordoma, a rare malignant primary bone tumor, has invaded the skull base and cervical spine, creating brain stem compression (top). Post-surgery (bottom) the tumor is gone and the compression is released. 


Many state-of-the art technologies are utilized including advanced endoscopic integration of multi-modality imaging techniques and image guidance, and highly specific surgical instrumentation. Using all the patient data from imaging, physiology, and real time visualization allows for enhanced surgical precision in areas with a high concentration of delicate anatomy,” said Dr. Alden.

“We have a dedicated operative team of technologists, surgeons and nurses who work together regularly. This type of commitment is critical in order to safely perform these often complicated surgeries,” said Dr. Rastatter.

“We are happy to be able to bring all of these pediatric resources together to treat even our youngest patients,” said Dr. Alden, “opening the door for more options for these children.”