Optimization of the algorithm for diagnosis, management, and surgical treatment of parameningeal tumors in children

Abstract

Objective. To optimize an algorithm for the management of children and adolescents with parameningeal tumors based on a comprehensive assessment of diagnostic and therapeutic efficacy in this type of tumors. Patients and methods. The article presents a retrospective study and prospective evaluation of follow-up of 249 patients who underwent surgical treatment in the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology and in the Russian Children’s Clinical Hospital (Pirogov Russian National Research Medical University) from January 2003 to September 2021. The study included 139 patients with juvenile nasopharyngeal angiofibroma, 82 patients with fibro-osseous lesions, and 28 patients with parameningeal rhabdomyosarcoma. The follow-up period was at least 1 calendar month. Results. A comparative analysis of the efficacy of preliminary diagnosis of parameningeal tumors depending on the nosology was described; analysis of patient safety during the intra- and postoperative periods, postoperative adaptation, surgical radicality and survival analysis according to the surgical treatment method was performed; algorithm for the management of patients with parameningeal tumors was described. Conclusion. It is advisable to introduce the algorithm developed by the authors into routine clinical practice to optimize medical care for children and adolescents with parameningeal tumors. Key words: children, tumors, parameningeal site, surgical interventions, juvenile angiofibroma, juvenile ossifying fibroma, rhabdomyosarcoma