Journal of Korean Neurosurgical Society最新文献

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Large Language Model and Pediatric Neurosurgery - A Neurosurgeon's Perspective on the Artificial Nervous System. 大型语言模型和儿童神经外科-神经外科医生对人工神经系统的看法。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-30 DOI: 10.3340/jkns.2026.0029
Woon Tak Yuh, Seung-Jun Ryu, Tae-Shin Kim, Il Choi
{"title":"Large Language Model and Pediatric Neurosurgery - A Neurosurgeon's Perspective on the Artificial Nervous System.","authors":"Woon Tak Yuh, Seung-Jun Ryu, Tae-Shin Kim, Il Choi","doi":"10.3340/jkns.2026.0029","DOIUrl":"https://doi.org/10.3340/jkns.2026.0029","url":null,"abstract":"<p><p>Large language models (LLMs) are rapidly transforming healthcare, yet their implications for pediatric neurosurgery remain underexplored. This narrative review interprets LLM evolution through a neuroscientific lens familiar to pediatric neurosurgeons. We trace the parallel development of LLMs and the human brain: architecture evolving from sequential processing to attention mechanisms mirrors prefrontal cortex maturation; training stages parallel synaptic exuberance, adolescent pruning, and socialization; reasoning capabilities emerge through chain-of-thought prompting and reinforcement learning, analogous to deliberate cognitive processing. We then examine capabilities current LLMs lack but would require for artificial general intelligence-continual learning, multimodal perception, self-awareness, world models, and physical embodiment-mapping each to corresponding neural functions. Using a representative case of pediatric medulloblastoma, we illustrate how these technologies will reshape clinical practice, surgery, research, and education. Current frontier models deliver excellent medical performance with multimodal reasoning at low cost, yet pediatric neurosurgery presents a \"long-tail\" challenge where rare conditions and reliance on expert consensus demand domain-specific augmentation. The emergence of agentic artificial intelligence (AI), physical AI, and autonomous research systems signals a shift from AI as advisory tool to executing partner. LLMs externalize intellectual labor at unprecedented scale, redefining physicians as \"responsible interpreters\" who orchestrate AI while retaining judgment, accountability, and ethical authority. In pediatric neurosurgery, this role uniquely integrates metacognitive and emotional dimensions beyond AI's reach within the child-caregiver-physician relationship, enabling human-centered care and empowering neurosurgeons to actively shape AI integration rather than merely adapt to it.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atypical Posterior Reversible Encephalopathy Syndrome with Intraventricular Hemorrhage in a Patient with Eclampsia : A Case Report. 子痫患者不典型后可逆脑病综合征伴脑室内出血1例报告。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-30 DOI: 10.3340/jkns.2026.0038
Woo Hyeong Park, Sang-Koo Lee, Young Jin Kim, Jung-Ho Yun, Jaewoo Chung, In-Ho Jung, Sung Jin Kim, Bae Tae Woong, Chun-Sung Cho
{"title":"Atypical Posterior Reversible Encephalopathy Syndrome with Intraventricular Hemorrhage in a Patient with Eclampsia : A Case Report.","authors":"Woo Hyeong Park, Sang-Koo Lee, Young Jin Kim, Jung-Ho Yun, Jaewoo Chung, In-Ho Jung, Sung Jin Kim, Bae Tae Woong, Chun-Sung Cho","doi":"10.3340/jkns.2026.0038","DOIUrl":"https://doi.org/10.3340/jkns.2026.0038","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome (PRES) typically involves parieto-occipital regions but rarely presents with extensive central involvement and intraventricular hemorrhage (IVH). We report a rare case of atypical PRES with extensive central involvement and IVH in a patient with eclampsia, emphasizing diagnostic challenges and favorable outcomes. Initial CT showed IVH in all ventricles and bilateral basal ganglia hypodensities. Following emergency cesarean section, brain MRI revealed typical parieto-occipital vasogenic edema along with atypical involvement of the pons, midbrain, bilateral basal ganglia, and thalami, consistent with a central variant of PRES. Susceptibility-weighted imaging showed microhemorrhages in the basal ganglia, while MR venography excluded cerebral venous thrombosis. Conservative management with strict blood pressure control and seizure prophylaxis resulted in complete radiological resolution on follow-up imaging, and the patient was discharged without neurological deficits. Prompt recognition of atypical PRES patterns prevents misdiagnosis and unnecessary interventions despite severe radiological findings.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Generative AI-Assisted Medical Illustrations in Pediatric Neurosurgery: Workflows, Ethical Safeguards, and Journal Policy Considerations. 生成人工智能辅助儿科神经外科医学插图:工作流程,道德保障和期刊政策考虑。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-30 DOI: 10.3340/jkns.2026.0037
Jun Kyu Hwang, Dong-Su Jang
{"title":"Generative AI-Assisted Medical Illustrations in Pediatric Neurosurgery: Workflows, Ethical Safeguards, and Journal Policy Considerations.","authors":"Jun Kyu Hwang, Dong-Su Jang","doi":"10.3340/jkns.2026.0037","DOIUrl":"https://doi.org/10.3340/jkns.2026.0037","url":null,"abstract":"<p><p>Generative artificial intelligence (AI) has emerged as a transformative tool for creating high-quality visual materials in medical research and education. In pediatric neurosurgery, where ethical and legal constraints limit the use of real patient photographs, AI-assisted illustrations offer significant potential. However, concerns regarding clinical accuracy, intellectual property, and the protection of vulnerable pediatric patients necessitate rigorous oversight. We present a human-in-the-loop workflow that integrates generative AI with vector-based digital editing to produce scientifically accurate and ethically grounded medical illustrations. We reviewed current AI usage policies from major medical journals, including the International Committee of Medical Journal Editors (ICMJE) and the Journal of Korean Neurosurgical Society (JKNS). To demonstrate practical application, we developed illustrative examples for conditions such as sacral dimple, Crouzon syndrome, and Down syndrome using clinician-led sketches and AI-assisted refinement. Vector-based workflows facilitate the transformation of AI-generated raster drafts into editable, high-resolution graphics, allowing clinicians to correct \"hallucinations\" and ensure anatomical precision. While most journals prohibit listing AI as an author, they permit its use for conceptual figures provided there is transparent disclosure of the tools and prompts used. Our proposed workflow emphasizes that AI should function as a \"constrained assistant\" rather than an autonomous creator, ensuring that the final output remains non-identifiable and respectful of pediatric patients' dignity. Generative AI tools can significantly enhance visualization in pediatric neurosurgery when governed by strict ethical and technical safeguards. Adherence to journal policies and the maintenance of human-directed validation are essential to uphold scientific integrity and patient privacy in the era of AI-assisted publishing.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Robotic Surgery in Pediatric Epilepsy : Current Evidence, Clinical Impact, and Future Directions. 机器人手术在儿童癫痫:目前的证据,临床影响和未来的方向。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-29 DOI: 10.3340/jkns.2026.0052
Seunghoon Lee
{"title":"Robotic Surgery in Pediatric Epilepsy : Current Evidence, Clinical Impact, and Future Directions.","authors":"Seunghoon Lee","doi":"10.3340/jkns.2026.0052","DOIUrl":"https://doi.org/10.3340/jkns.2026.0052","url":null,"abstract":"<p><p>Pediatric drug-resistant epilepsy remains a significant neurological challenge, with up to one-third of affected children failing to achieve seizure control with pharmacologic therapy. Surgical intervention offers the greatest likelihood of seizure reduction or freedom; however, precise localization and treatment of epileptogenic networks in pediatric patients are often complicated by multilobar onset patterns, evolving neurodevelopmental anatomy, and limitations of conventional invasive monitoring. Over the past two decades, stereoelectroencephalography (SEEG) has emerged as a preferred invasive diagnostic modality due to its minimally invasive approach, three-dimensional sampling capability, and favorable safety profile. Parallel advances in robotic stereotaxy have further enhanced the precision, efficiency, and reproducibility of electrode implantation and stereotactic interventions. Robotic assistance has expanded beyond diagnostic SEEG implantation to include stereotactic ablative therapies, such as radiofrequency thermocoagulation and magnetic resonance-guided laser interstitial thermal therapy, as well as neuromodulation procedures including deep brain stimulation and responsive neurostimulation. These technologies enable precise targeting of deep and distributed epileptogenic networks while minimizing surgical morbidity. Pediatric clinical studies demonstrate that robotic-assisted SEEG achieves high diagnostic yield, excellent safety profiles, and accuracy comparable to or exceeding conventional stereotactic techniques. Similarly, robot-assisted ablative and neuromodulation procedures show promising efficacy in carefully selected pediatric populations, although complete seizure freedom remains less common in neuromodulatory approaches. Despite increasing adoption, the pediatric robotic epilepsy surgery literature remains predominantly retrospective and heterogeneous, with limited prospective comparative data. This review synthesizes current evidence regarding robotic applications in pediatric epilepsy surgery, including SEEG implantation, stereotactic ablation, and neuromodulation. We highlight technical considerations, clinical outcomes, and safety profiles, while identifying critical gaps in evidence related to long-term outcomes, and the direct clinical impact of robotic accuracy. Continued prospective and multicenter investigations are essential to define the optimal role of robotic assistance in improving outcomes for pediatric patients with drug-resistant epilepsy.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From Static Diagnosis to Dynamic Guidance : Evolution of Artificial Intelligence in Pediatric Neuroimaging. 从静态诊断到动态引导:儿童神经影像学人工智能的发展。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-27 DOI: 10.3340/jkns.2026.0030
Boa Jang, Youmin Shin, Geonhee Lee, Young-Gon Kim
{"title":"From Static Diagnosis to Dynamic Guidance : Evolution of Artificial Intelligence in Pediatric Neuroimaging.","authors":"Boa Jang, Youmin Shin, Geonhee Lee, Young-Gon Kim","doi":"10.3340/jkns.2026.0030","DOIUrl":"https://doi.org/10.3340/jkns.2026.0030","url":null,"abstract":"<p><p>The pediatric brain represents a dynamic biological target characterized by rapid myelination and functional reorganization, which presents unique challenges for conventional, adult-centric artificial intelligence (AI) models. This review provides a structured overview of the evolution of AI applications in pediatric neuroimaging and neurosurgery, tracing the transition from early standardized pipelines and handcrafted imaging biomarkers to contemporary deep learning-based approaches for segmentation, prediction, and anomaly detection. Recent advances indicate a paradigm shift from static image interpretation toward dynamic and interactive intelligence, in which AI systems actively support clinical decision-making during surgery rather than functioning solely as diagnostic tools. This new paradigm is supported by four technological domains : brain foundation models designed to capture age-aware neurodevelopmental representations; spatial computing technologies for three-dimensional, context-aware-visualization; physical AI systems integrating robotic safety constraints; and multimodal AI agents that act as cognitive surgical copilots by synthesizing imaging, physiological, and intraoperative data in real time. By shifting the role of AI from preoperative assessment to intraoperative guidance, this paradigm offers new opportunities to enhance surgical precision, safety, and workflow efficiency in pediatric neurosurgery. This review aims to provide neurosurgeons with a conceptual framework for understanding and adopting next-generation AI technologies that align with the dynamic nature of the developing brain and the clinical demands of pediatric neurosurgical care.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interpretation Challenges of Intraoperative Neurophysiological Monitoring Waveforms: A Technical Note. 术中神经生理监测波形的解读挑战:技术说明。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-27 DOI: 10.3340/jkns.2026.0082
Byeong Ho Oh, Hyeong Cheol Moon, Jae Hoon Woo, Jong Beom Lee
{"title":"Interpretation Challenges of Intraoperative Neurophysiological Monitoring Waveforms: A Technical Note.","authors":"Byeong Ho Oh, Hyeong Cheol Moon, Jae Hoon Woo, Jong Beom Lee","doi":"10.3340/jkns.2026.0082","DOIUrl":"https://doi.org/10.3340/jkns.2026.0082","url":null,"abstract":"<p><p>Intraoperative neurophysiological monitoring (IONM) using motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) is widely used during neurosurgical procedures to reduce the risk of postoperative neurological deficits. However, interpretation of intraoperative waveforms is often challenging because signal changes do not always clearly meet established alarm criteria. In this technical note, we present representative patterns of normal, uncertain, and abnormal IONM waveforms and discuss interpretative challenges associated with ambiguous recordings. A retrospective descriptive review was performed on seven adult patients who underwent neurosurgical procedures with intraoperative MEP and SEP monitoring. Waveforms were qualitatively categorized based on morphology, amplitude, latency, and reproducibility across repeated stimulations. Normal waveforms demonstrated stable morphology, reproducible amplitudes, and physiologic latency ranges. Abnormal waveforms showed marked signal attenuation or complete loss of reproducible responses. In contrast, uncertain waveforms exhibited partial amplitude reduction, fluctuating morphology, limited reproducibility, or latency values overlapping normal ranges despite qualitative instability. These equivocal patterns could not be reliably classified using conventional binary alarm criteria alone. Our observations suggest that intraoperative MEP and SEP interpretation cannot always be reduced to a binary normal-versus-abnormal framework. Recognition of an intermediate \"uncertain\" waveform category may improve contextual intraoperative assessment, prompt careful reassessment of reversible factors, and better reflect the dynamic complexity of neuromonitoring.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thirty-Five Years of the Korean Brain Tumor Society (1991-2026): A Historical Review. 韩国脑肿瘤学会35年(1991-2026):历史回顾。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-27 DOI: 10.3340/jkns.2026.0117
Youngbeom Seo, Eui Hyun Kim, Shin-Hyuk Kang
{"title":"Thirty-Five Years of the Korean Brain Tumor Society (1991-2026): A Historical Review.","authors":"Youngbeom Seo, Eui Hyun Kim, Shin-Hyuk Kang","doi":"10.3340/jkns.2026.0117","DOIUrl":"https://doi.org/10.3340/jkns.2026.0117","url":null,"abstract":"<p><p>The Korean Brain Tumor Society (KBTS) was established in 1991 as the Korean Brain Tumor Study Group and has since evolved into a leading multidisciplinary academic organization in neuro-oncology. In its early phase, the society focused on building essential academic infrastructure, including the initiation of a nationwide brain tumor registry in 1992 and the implementation of structured educational programs. In 1999, this organization was renamed the Korean Brain Tumor Society, reflecting its expanding academic scope. In 2002, the KBTS launched the Journal of Korean Brain Tumor Society, establishing an official platform for scholarly communication. During the 2000s, the society expanded its academic and international engagement through scientific meetings-including the 2nd Meeting of the Asian Society for Neuro-Oncology (ASNO) in 2003 and the 7th ASNO Meeting in 2010-regional collaborations, and its admission to the Korean Academy of Medical Sciences in 2007. A major transition occurred in 2011 when its official journal, which was subsequently relaunched in 2013 as Brain Tumor Research and Treatment (BTRT), was integrated with the Journal of Korean Society for Neuro-Oncology, marking a strategic step toward internationalization. In 2018, the publication of the comprehensive textbook \"Brain Tumors\" further strengthened the society's academic foundation. In 2020, despite the challenges posed by the coronavirus disease 2019 pandemic, the KBTS maintained continuity through adaptive academic activities and the development of clinical recommendations. In 2022, the society successfully hosted the World Federation of Neuro-Oncology Societies in Seoul, underscoring its growing global leadership. This trajectory culminated in 2025, with the indexing of BTRT in Scopus, representing a significant milestone in international academic recognition. Over the past 35 years, the KBTS has made substantial contributions to research, education, and international collaboration while advancing clinical practice and surgical management through multicenter studies and the dissemination of operative strategies.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preface : Digital and Robotic Transformation of Pediatric Neurosurgery. 前言:儿童神经外科的数字化和机器人转型。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-27 DOI: 10.3340/jkns.2026.0115
Ji Hoon Phi, Seung-Ki Kim
{"title":"Preface : Digital and Robotic Transformation of Pediatric Neurosurgery.","authors":"Ji Hoon Phi, Seung-Ki Kim","doi":"10.3340/jkns.2026.0115","DOIUrl":"https://doi.org/10.3340/jkns.2026.0115","url":null,"abstract":"<p><p>This Pediatric Issue of the Journal of Korean Neurosurgical Society addresses the digital and robotic transformation of pediatric neurosurgery. It reviews the emerging applications of artificial intelligence and related technologies across diagnosis, monitoring, surgical practice, education, and communication, while also considering the unique scientific and ethical challenges of their use in children. Together, these articles offer a timely perspective on the future of safer, more precise, and more personalized pediatric neurosurgical care.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biportal Endoscopic Transorbital Approach with an Accessory Lateral Orbital Port for Anterior Petrosal Corridor : A Cadaveric Feasibility Study [Seven-004]. 双门静脉内窥镜经眶入路及副外侧眶口用于岩前通道的可行性研究[7 -004]。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-09 DOI: 10.3340/jkns.2026.0049
Seonah Choi, Woo Hyun Kim, Soo Jeong Park, Tae Hoon Roh, Hong-Gyu Yoon, Chang-Ki Hong, Je Beom Hong
{"title":"Biportal Endoscopic Transorbital Approach with an Accessory Lateral Orbital Port for Anterior Petrosal Corridor : A Cadaveric Feasibility Study [Seven-004].","authors":"Seonah Choi, Woo Hyun Kim, Soo Jeong Park, Tae Hoon Roh, Hong-Gyu Yoon, Chang-Ki Hong, Je Beom Hong","doi":"10.3340/jkns.2026.0049","DOIUrl":"https://doi.org/10.3340/jkns.2026.0049","url":null,"abstract":"<p><strong>Objective: </strong>The anterior transpetrosal approach (ATPA) is one of the useful methods for targeting the middle clival and ventrolateral pontine areas. Thanks to the advances in endoscopic skull base surgery, there have been increased attempts to perform anterior petrosectomy via the endoscopic transorbital approach (ETOA), although some limitations and drawbacks have also been suggested. This study aimed to analyze the contribution of the endoscopic biportal transorbital technique to anterior petrosectomy.</p><p><strong>Methods: </strong>A total of ten cadaveric heads (twenty sides) were dissected at the Surgical Neuroanatomy Laboratory. The biportal ETOA was established by combining the main transorbital port with an accessory lateral orbital port created beyond the lateral orbital rim. In each head, anterior petrosectomy through uniportal ETOA was performed on one side, followed by the biportal ETOA on the same side, while the transcranial subtemporal ATPA was done on the other side. The extent of exposure for each approach was documented using representative photographs obtained during dissection. The angle of attack (AOA) was measured at key surgical landmarks, including Meckel's cave, the root entry zone (REZ) of cranial nerves V, VI, VII, and VIII, and the internal acoustic porus. The drilled volume of the petrous apex was calculated by comparing pre- and post-dissection CT scans.</p><p><strong>Results: </strong>By utilizing the accessory port, it was possible to obtain a more medial trajectory, allowing wider exposure of CN V, CN VI, CN VII, CN VIII, and the ventrolateral pons than the uniportal approach. The angle of attack (AOA) increased with the biportal transorbital approach compared to the uniportal route by approximately 26.1-46.7% in the horizontal axis, 21.6-52.4% in the vertical axis. When measuring the drilled volume of the petrous apex, no statistically significant difference was observed between the biportal ETOA and the traditional transcranial craniotomy method. (0.9339 ± 0.1037 vs 0.9729 ± 0.0692 cm3, p = 0.067).</p><p><strong>Conclusion: </strong>This study demonstrates that the biportal ETOA can compensate for the limitations of the uniportal approach in performing anterior petrosectomy by providing a wider field of view and greater surgical freedom.m neurodevelopmental outcomes in vulnerable pediatric neurosurgical patients.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Emerging Role of Artificial Intelligence in Pediatric Neuroanesthesia. 人工智能在小儿神经麻醉中的新作用。
IF 1.7 4区 医学
Journal of Korean Neurosurgical Society Pub Date : 2026-04-09 DOI: 10.3340/jkns.2026.0033
Jung-Bin Park, Young-Eun Jang
{"title":"An Emerging Role of Artificial Intelligence in Pediatric Neuroanesthesia.","authors":"Jung-Bin Park, Young-Eun Jang","doi":"10.3340/jkns.2026.0033","DOIUrl":"https://doi.org/10.3340/jkns.2026.0033","url":null,"abstract":"<p><p>Anesthesia for pediatric neurosurgery represents a highly complex and challenging field, characterized by age-dependent physiological variability, heterogeneous patient populations, and the critical need to protect the developing central nervous system. Conventional clinical approaches often rely on adult-derived data, which may inadequately reflect the distinct neurophysiological and hemodynamic characteristics of neonates, infants and children. Recent advances in artificial intelligence (AI) have enabled the integration of multimodal perioperative data, including physiologic signals and neurophysiologic monitoring, with the aim of supporting clinical decision-making in complex surgical settings. This review summarizes the current landscape of AI applications relevant to pediatric anesthesia, with particular attention to preoperative risk assessment, airway management, and real-time prediction of intraoperative adverse events such as hypoxemia and hemodynamic instability. Although AI-based approaches have demonstrated encouraging results in adult populations, their application to pediatric neuroanesthesia remains limited. The integration of AI into this field faces several distinct challenges, including the scarcity of high-quality datasets for rare neurosurgical conditions, substantial heterogeneity across developmental stages, and difficulties in aligning model outputs with clinically interpretable physiologic mechanisms. Addressing these limitations will require the development of explainable, physiology-informed AI frameworks and disease-specific models tailored to conditions such as moyamoya disease or complex craniofacial reconstruction. Ultimately, AI should be positioned as an adjunctive decision-support tool that complements, rather than replaces, anesthesiologists' expertise. Through multidisciplinary collaboration and human-centered implementation, AI may contribute to improved perioperative safety and long-term neurodevelopmental outcomes in vulnerable pediatric neurosurgical patients.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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