Journal of Neurological Surgery Part B: Skull Base最新文献

{"title":"Corrigendum: Presentation Abstracts of the North American Skull Base Society.","authors":"","doi":"10.1055/s-0045-1811603","DOIUrl":"10.1055/s-0045-1811603","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/s-015-61030.][This corrects the article DOI: 10.1055/s-0045-1803264.].</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"86 Suppl 1","pages":"e3"},"PeriodicalIF":0.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Presentation Abstracts of the North American Skull Base Society.","authors":"","doi":"10.1055/s-0045-1809309","DOIUrl":"10.1055/s-0045-1809309","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/s-015-61030.][This corrects the article DOI: 10.1055/s-0045-1803753.][This corrects the article DOI: 10.1055/s-0045-1803827.].</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"86 Suppl 1","pages":"e1"},"PeriodicalIF":0.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Prognosis of Delayed Facial Nerve Palsy After Vestibular Schwannoma Resection: Systematic Review and Meta-analysis.","authors":"Ashton Huppert Steed, Katherine Riordan, Melissa Papuc, Alma Jukic, Kory A Johnson, Annie Pico, Mazen Zaher, Pedro Aguilar-Salinas, Peter Nakaji","doi":"10.1055/a-2587-6401","DOIUrl":"10.1055/a-2587-6401","url":null,"abstract":"<p><strong>Objective: </strong>Delayed facial nerve palsy (DFNP) is a complication of microsurgical resection of vestibular schwannoma (VS). This study aims to clarify the definition and incidence of DFNP, as well as evaluate long-term CNVII prognosis in affected patients.</p><p><strong>Databases reviewed: </strong>PubMed, Embase, and Scopus databases.</p><p><strong>Methods: </strong>A systematic literature search was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Full-text publications were included if they reported DFNP incidence, CNVII prognosis, demographic data, and how they defined DFNP.</p><p><strong>Results: </strong>Ten studies with 2,122 patients who underwent surgical resection for VS were included. Meta-analysis demonstrated a mean incidence of DFNP of 13%, with a mean recovery to House-Brackmann (HB) I/II of 85%. Definitions of DFNP varied widely. Four studies utilized a broad definition of DFNP, without requiring any specific level of change in HB grade in the postoperative period. Two studies defined DFNP as deterioration of CNVII function by at least one HB grade, and an additional four studies defined DFNP as deterioration of CNVII function by at least two HB grades.</p><p><strong>Conclusion: </strong>The prognosis of CNVII function after DFNP was favorable with 85% of patients regaining function to HB grade I/II within 12 months. Given the heterogeneity in definitions of DFNP, it remains challenging to determine the true incidence of DFNP after VS resection. Grading DFNP by degree of severity would improve studies of this entity. We propose utilizing a novel DFNP Severity Scale to more accurately track prognosis in patients with DFNP based on pre- and postoperative HB scores.</p><p><strong>Level of evidence: </strong>Level III-systematic review of nonrandomized cohort studies and retrospective reviews.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"123-130"},"PeriodicalIF":0.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Posterior Fossa Morphometric Analyses with Cerebrospinal Fluid Flow Parameters in Patients with Chiari Malformation Type 1.","authors":"Samet Dinc, Aynur Turan, Rafet Ozay, Sahin Hanalioglu","doi":"10.1055/a-2590-6293","DOIUrl":"10.1055/a-2590-6293","url":null,"abstract":"<p><strong>Objectives: </strong>Chiari malformation (CM) is a congenital condition characterized by herniating cerebellar tonsils (HCTs) into the spinal canal. Although mostly managed through posterior decompression surgery, there is a lack of consensus about the need for surgery in asymptomatic patients or those with mild clinical findings. This study aimed to evaluate cerebrospinal fluid (CSF) flow parameters in patients with CM type 1 (CM-1) and compare them with posterior cranial fossa (PCF) morphometric measurements to use these measurements for predicting disease progression.</p><p><strong>Design: </strong>Retrospective analysis.</p><p><strong>Setting: </strong>Department of Neurosurgery, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Health Sciences University Participants: Adult patients ( <i>n</i>  = 95; mean age = 40.8 ± 13.8 years; 76 females) diagnosed with CM-1 between January 2017 and October 2018.</p><p><strong>Main outcome measures: </strong>Symptoms at presentation, CSF flow score, PCF morphometric measurements-measured using brain and spinal cord magnetic resonance imaging and computed tomography.</p><p><strong>Results: </strong>Coughing headache, presence of additional pathology (syringomyelia), PCF volume and height, Boogard's angle, foramen magnum surface area, HCT length, and HCT surface area (HCTSA) were significant factors affecting CSF flow. Further, multivariate regression analysis revealed that the HCT length and HCTSA, the presence of additional pathology, and Boogard's angle were independent predictors of CSF flow scores.</p><p><strong>Conclusion: </strong>The morphometric measures, HCT length, HCTSA, and Boogard's angle, and the presence of additional pathology are important predictive factors for reduced CSF flow at the craniovertebral junction in patients with CM-1. These factors can help clinicians predict the disease's clinical progression and plan surgical treatment.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"225-233"},"PeriodicalIF":0.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Routine Lumbar Drains Necessary for Endoscopic Reconstruction after Resection of Anterior and Central Skull Base Tumors?","authors":"Jacob C Harris, David K Lerner, Iulia Tapescu, Alan D Workman, Jennifer E Douglas, Michael A Kohanski, Christina Jackson, John Y K Lee, Philip B Storm, James N Palmer, Nithin D Adappa","doi":"10.1055/a-2575-4718","DOIUrl":"10.1055/a-2575-4718","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The expanded endonasal approach (EEA) is historically associated with high rates of postoperative cerebrospinal fluid (CSF) leak. Therefore, many surgeons advocate for routine lumbar drain (LD) placement despite mixed evidence of their efficacy. We report outcomes for anterior and central skull base reconstructions after EEA without LDs.</p><p><strong>Design setting and participants: </strong>A retrospective review was conducted evaluating consecutive patients undergoing EEAs for resection of central and anterior skull base pathology from 2015 to 2024 at two academic institutions.</p><p><strong>Main outcome measures: </strong>Incidence of postoperative CSF leak.</p><p><strong>Results: </strong>Eighty-five patients underwent a total of 89 EEAs. Patients were predominantly female (62.9%) with an average age of 45.1 years (range 11 months-84 years). Tumors included primarily craniopharyngiomas (49.4%) and meningiomas (46.1%). No LDs were placed perioperatively, and there was an 100% intraoperative high-flow CSF leak rate. Skull base reconstruction was performed using pedicled nasoseptal flaps (NSFs) in all cases, tensor fascia lata grafts in 82 cases, and fat grafts in 78 cases. The postoperative CSF leak rate was 7.9%. Suprasellar tumors were associated with lower rates of postoperative CSF leak compared with tuberculum sella and planum sphenoidale pathology ( <i>p</i>  = 0.030), whereas meningiomas trended toward higher CSF leak rates compared with craniopharyngiomas ( <i>p</i>  = 0.059).</p><p><strong>Conclusion: </strong>We report a low rate of postoperative CSF leak without LD placement after EEA. Our results suggest that successful skull base reconstructions may be performed with multilayered closures using vascularized NSFs without the need for routine CSF diversion.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"157-164"},"PeriodicalIF":0.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-invasive Anterior Petrosal Intertentorial Approach for Trigeminal Neuralgia: Rationale and Limits of the Technique.","authors":"L Giammattei, J W Squair, D Peters, A Fava, A Mellal, V Aureli, S Pistocchi, D Starnoni, R T Daniel","doi":"10.1055/a-2587-6267","DOIUrl":"10.1055/a-2587-6267","url":null,"abstract":"<p><strong>Background and objectives: </strong>The retrosigmoid approach (RSA) is considered the standard surgical choice to address a neurovascular conflict involving the trigeminal nerve. The subtemporal transtentorial approach (STA) represents the main alternative. We describe here the mini-invasive anterior petrosal intertentorial approach with a view to reduce complications associated with the standard STA.</p><p><strong>Methods: </strong>Mini-invasive anterior petrosal intertentorial approach (M-APIA) was described for a case of refractory trigeminal neuralgia. This approach includes a very limited amount of drilling of the petrous ridge to expose the posterior fossa dura and the superior petrosal sinus to facilitate the subsequent tentorial peeling. Tentorial peeling enables to develop an intertentorial plane between the temporal tentorial leaf (TTL) and the posterior fossa tentorial leaf (PFTL). A linear incision over the posterior fossa dura and the PFTL offers a wide exposure of the neurovascular conflict.</p><p><strong>Results: </strong>M-APIA enables to expose the root entry zone (REZ) of the trigeminal nerve without exposing the temporal lobe or the cerebellum.</p><p><strong>Conclusion: </strong>M-APIA can be considered as a safe alternative to the RSA or STA for trigeminal microvascular decompression (MVD), especially for select cases. Additional studies are needed for a better understanding of its advantages and disadvantages.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"144-150"},"PeriodicalIF":0.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory Foramina Presence Significantly Narrows the Jugular Foramen: Anatomical Study with Potential Neurosurgical Significance.","authors":"George Triantafyllou, Ioannis Paschopoulos, Panagiotis Papadopoulos, Sabino Luzzi, Renato Galzio, Łukasz Olewnik, George Tsakotos, Nicol Zielinska, Piotr Łabętowicz, Maria Piagkou","doi":"10.1055/a-2587-5982","DOIUrl":"10.1055/a-2587-5982","url":null,"abstract":"<p><strong>Introduction: </strong>The jugular foramen (JF) is a critical anatomical structure that houses the lower cranial nerves (IX, X, and XI), making it a key focus in neurosurgical procedures. Variations, such as ossified dural septations within the JF, can significantly impact surgical outcomes. The present study investigates the incidence and impact of these ossifications on JF morphometry, providing insights crucial for surgical planning and execution.</p><p><strong>Materials and methods: </strong>We analyzed bilaterally 120 adult dried skulls to assess the presence of accessory foramina (AF), proposing that these represent ossified dural septations. Morphometric measurements of the JF, including height and width, were taken in both cases with and without AF with the use of digital caliper. A thorough literature review was conducted to correlate the findings with clinical implications, and statistical analyses were used to determine significant morphological differences.</p><p><strong>Results: </strong>A complete AF was identified in 2.92% of skulls and an incomplete one in 0.42%. Ossified dural septations were associated with significantly reduced JF height and width. This reduction may hinder intraoperative manipulation, especially of the lower cranial nerves, increasing the potential for complications.</p><p><strong>Conclusion: </strong>The findings underscore the need to recognize JF variants, especially ossified septations, in neurosurgical practice. These variants can complicate surgical approaches to the skull base, highlighting the need for careful preoperative assessment. Future studies are warranted to explore the clinical ramifications of these findings, particularly to patient outcomes in skull base surgeries.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"e59-e64"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Esthesioneuroblastoma at a Single Tertiary Care Center.","authors":"Evan J Patel, Christine Glastonbury, Annemieke van Zante, Sue S Yom, Michael McDermott, Philip Theodosopoulos, Manish Aghi, Ezequiel Goldschmidt, Ivan El-Sayed","doi":"10.1055/a-2587-6160","DOIUrl":"10.1055/a-2587-6160","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze management strategies and outcomes for patients with esthesioneuroblastoma (ENB) undergoing surgical resection at a single institution.</p><p><strong>Methods: </strong>Retrospective review from 1971 to 2022 from a single, high-volume tertiary academic center of all patients with ENB.</p><p><strong>Results: </strong>A total of 60 patients received their primary treatment for ENB at our institution. The average age at diagnosis was 52 years (range 13-91), and most were male (66.7%) with Kadish C (61.7%) stage at presentation. Most patients were treated with an open approach (68.3%) compared with a purely endoscopic approach (31.7%). Median follow-up was 96.9 months (mean 118.8 months, interquartile range 28.4-183.8 months). There was one patient with local recurrence in the endoscopic cohort (5.3%) compared with 22.0% (9 patients) among those who underwent an open resection ( <i>p</i>  = 0.21). The 5-year survival was 87.2% (95% CI, 71.9-100.0%) in the endoscopic cohort compared with 80.2% (95% CI, 68.8-93.5%) in the open group ( <i>p</i>  = 0.60). The rate of death or recurrence within 5 years of treatment was comparable between open and endoscopic (32.5% vs. 15.0%, <i>p</i>  = 0.26). Among Kadish C patients treated in the endoscopic era (after 2006), 5-year survival was 76.2% (95% CI, 52.1-100.0%) in the endoscopic cohort and 64.8% (95% CI, 39.3-100.0%) in the open group ( <i>p</i>  = 0.70).</p><p><strong>Conclusion: </strong>The surgical approach for ENB resection is dictated by tumor extension. Endoscopic resection offers a less invasive approach with comparable postoperative outcomes in appropriately selected patients.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"117-122"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Supraorbital Keyhole Craniotomy Approach for Olfactory Implantation: A Radiological Feasibility Study.","authors":"Lauren J Sterlin, Arman Saeedi, William C Broaddus, Daniel H Coelho","doi":"10.1055/a-2576-7408","DOIUrl":"10.1055/a-2576-7408","url":null,"abstract":"<p><strong>Objectives: </strong>Olfactory implants to address anosmia have gained interest in recent years. Existing transnasal and transcranial approaches to the olfactory bulb (OB) have potential complications. We aim to determine whether transcranial supraorbital keyhole craniotomy (SOKC) provides adequate and safe access to the OB. Secondary outcomes include highlighting specific anatomical obstructions and impacts of patient characteristics.</p><p><strong>Study design: </strong>This is a retrospective cohort study.</p><p><strong>Setting: </strong>This study was conducted at the Tertiary Academic Medical Center.</p><p><strong>Methods: </strong>Fifty fine-cut computed tomographies of the sinuses in consecutive adult patients (50% male) were analyzed. Image processing was performed using syngo.via to assess whether there was a clear path from points on the exterior skull to the anterior or posterior OB. Using five points based on the SOKC technique on the exterior skull, lines were drawn from each point to the ipsilateral anterior and posterior OB resulting in 1,000 pathways. Pathways were reconstructed and analyzed for violations of the orbit, orbital bone, or sinuses.</p><p><strong>Results: </strong>A total of 96% of the subjects had at least one unobstructed pathway to the OB. The route most commonly unobstructed (90%) was 2P (2 cm above the supraorbital notch to posterior bulb). The posterior OB was less obstructed than the anterior (56, 112; <i>p</i>  = 0.00002). The most common obstruction was an ipsilateral sinus.</p><p><strong>Conclusion: </strong>The SOKC may be an effective and safe approach for an olfactory implant in many patients. The posterior OB had a clearer approach with less obstruction. By avoiding injury to the nasal mucosa, orbit, sinuses, or traversing the skull base, this approach may prove advantageous over transnasal approaches for olfactory implantation in select patients.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"e38-e43"},"PeriodicalIF":0.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gruber's Ligament is a Part of the Dura Mater: An Anatomical and Histological Study of Dorello's Canal Relevant to Skull Base Surgery.","authors":"Joe Iwanaga, Cara D Ramos, Rarinthorn Samrid, Joseph D Lockwood, Joseph R Keen, Blair M Barton, Vernard S Fennell, Noritaka Komune, Aaron S Dumont, R Shane Tubbs","doi":"10.1055/a-2575-4816","DOIUrl":"10.1055/a-2575-4816","url":null,"abstract":"<p><strong>Objective: </strong>Many studies have focused on Gruber's ligament and Dorello's canal. However, only scant studies have analyzed these structures via histological analysis. Furthermore, the histology studies for these structures did not sufficiently evaluate them and their surrounding anatomical relationships. Therefore, this study aims to assess the comprehensive morphology of Gruber's ligament and Dorello's canal.</p><p><strong>Materials and methods: </strong>Histological observation in coronal and sagittal sections and microsurgical observations (using both conventional and inferior approaches) were conducted on Gruber's ligament, Dorello's canal, and related structures.</p><p><strong>Results: </strong>Histological observation revealed that the only extension of the dura was found between the petrous apex and the clivus. Microsurgical dissection using the conventional approach identified a fibrous band, whereas the inferior approach did not reveal any distinct connective tissue other than dura. Our multidirectional approach demonstrated that Gruber's ligament is part of the dura between the petrous apex and clivus. The petrous apex end was artificially separated from the dura along the medial wall of the cavernous sinus. The previously reported variations of Gruber's ligament, such as duplication or absence, can now be explained by our findings.</p><p><strong>Conclusion: </strong>Gruber's ligament is simply a part of the dura at the skull base. The extension of the dura between the petrous apex and clivus, which forms part of a mesh-like structure rather than a distinct ligament, traditionally has been termed Gruber's ligament.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"e44-e51"},"PeriodicalIF":0.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}