# The Endonasal Endoscopic Transsphenoidal Approach to Paediatric Optic Chiasma Glioma: A Case Report and Literature Review

## TL;DR

This paper presents a successful case of using a minimally invasive endoscopic approach to treat a rare pediatric brain tumor near the optic nerve.

## Contribution

The paper demonstrates the feasibility of an endonasal endoscopic approach for pediatric optic chiasma glioma.

## Key findings

- The endoscopic endonasal transsphenoidal approach achieved subtotal resection of the tumor with no complications.
- The tumor was diagnosed as pilocytic astrocytoma, WHO grade 1.
- The case supports the use of this approach when carefully selected and managed by a multidisciplinary team.

## Abstract

Optic pathway gliomas (OPGs) are rare pediatric tumors that pose significant challenges in management due to their location and clinical manifestations. Traditional transcranial approaches have been the mainstay for surgical intervention, but recent advancements in endoscopic endonasal transsphenoidal surgery offer a less invasive alternative. Here, we present a case of a 10-year-old female child with neurofibromatosis type-1 and an aggressive OPG who underwent endoscopic endonasal transsphenoidal debulking surgery. The pre-operative evaluation confirmed complete vision loss, and imaging revealed tumor progression. The surgery was successful, resulting in a subtotal resection and a diagnosis of pilocytic astrocytoma, WHO grade 1. Post-operative assessments showed no complications. This case highlights the feasibility of the endoscopic endonasal transsphenoidal approach for OPGs and emphasizes the importance of careful patient selection and multidisciplinary collaboration in achieving successful outcomes for these challenging tumors.