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

{"title":"Incorporating AI-Driven Vision Systems to Quantify Learning Curve in EVD Placement.","authors":"Rupert D Smit, Aria Mahtabfar, Nikolaos Mouchtouris, Kevin Hines, Emil Swanepoel, David P Bray, James J Evans","doi":"10.1055/a-2642-1221","DOIUrl":"10.1055/a-2642-1221","url":null,"abstract":"<p><strong>Objectives: </strong>There is an application for artificial intelligence (AI) to augment medical education. The aim of this study was to incorporate AI-powered cameras to quantify the learning curve and performance metrics associated with external ventricular drain (EVD) placement.</p><p><strong>Methods: </strong>Fourteen participants, comprising medical students and neurosurgical residents, were recorded performing an EVD on a trainer head. Five panoramic cameras were installed within the simulation suite. The model employed convolutional neural networks to track anatomical landmarks and assess task completion. Quantification of the learning curve was achieved by aggregating scores across three phases: preparation, insertion, and closing. Additional metrics included fluidity, a proxy for surgical finesse.</p><p><strong>Results: </strong>The model successfully itemized parameters that characterize EVD placement. The study demonstrated a clear learning curve in EVD placement. The overall scores were 64.4/126 (51.1%), 99.6/126 (79%), and 113/126 (89.7%) for the students, junior residents, and senior residents ( <i>p</i>  < 0.0001). Significant improvements were observed in the preparation, insertion, and closing phases. The mean scores for preparation were 16.4/37 (44.3%), 25.6/37 (69.2), and 30.5/37 (82.4) for the students, junior residents, and senior residents ( <i>p</i>  < 0.0001). The mean scores for insertion were 26.2/44 (59.5%), 37.8/44 (85.9%), and 38.5/44 (87.5%) for the students, junior residents, and senior residents ( <i>p</i>  = 0.026). The mean scores during closing were 13/25 (52%), 22.2/25 (88.8%), and 25/25 (100%) for the students, junior residents, and senior residents ( <i>p</i>  = 0.0034). Fluidity improved significantly with training level ( <i>p</i>  = 0.0006).</p><p><strong>Conclusion: </strong>Our platform effectively quantified the learning curve associated with EVD placement, underscoring the importance of objective feedback and AI's potential to facilitate skill acquisition.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"373-382"},"PeriodicalIF":0.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391266","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":"Anatomical Variability of the Transverse and Sigmoid Sinus Grooves: Implications for Skull Base Surgery.","authors":"George Triantafyllou, Harris Pishiaras, Panagiotis Papadopoulos-Manolarakis, Ioannis Paschopoulos, George Tsakotos, Maria Piagkou","doi":"10.1055/a-2649-2161","DOIUrl":"10.1055/a-2649-2161","url":null,"abstract":"<p><strong>Introduction: </strong>The transverse and sigmoid sinus grooves (TSGs and SSGs) contain the corresponding sinuses within the posterior cranial fossa. Bony groove morphology remains insufficiently studied, while venous sinus variants are well-documented. The present study investigates the morphological variability of TSG and SSG and their clinical implications.</p><p><strong>Materials and methods: </strong>Ninety adult dried skulls were analyzed for the presence, width, and bony projections of the TSGs and SSGs. Emissary foramina (EF), including the mastoid emissary foramina (MEF) and posterior condylar canals (PCCs), were identified and measured. Statistical analysis assessed differences by side and sex, and correlations between groove dimensions were evaluated.</p><p><strong>Results: </strong>The SSG was present bilaterally in all specimens. Incomplete bony projections were identified in 27.2% of SSGs, more commonly on the left ( <i>p</i>  = 0.029). TSG was absent from 19.4% of sides, with bony prominences present in 7.8%. MEF were observed in 48.3% of SSGs, and occipital emissary foramina (OEF) in 9.1% of TSGs. A strong positive correlation was found between the widths of the SSG and TSG ( <i>R</i>  = 0.506, <i>p</i>  < 0.001).</p><p><strong>Conclusion: </strong>Significant morphological variability exists in the TSG and SSG, including bony bridges and EF. These features have direct surgical relevance, particularly in procedures such as retrosigmoid craniotomy, where accurate localization of venous structures is essential. Recognition of these variants is critical for surgical planning, minimizing intraoperative risk, and enhancing imaging interpretation in posterior cranial fossa and skull base approaches.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"e101-e105"},"PeriodicalIF":0.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391197","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":"Pedicled Nasoseptal Flap After Endoscopic Endonasal Resection of Skull Base Tumors: A Comparative Meta-Analysis with Other Modalities of Reconstruction.","authors":"Adriano M Lino-Filho, Mateus N F Fernandes, Otávio A De P M Teixeira, Júlia B Gomes, Weder S Borges-Junior, Leandro A de Camargo, Rodrigo Cavalcante","doi":"10.1055/a-2642-1155","DOIUrl":"10.1055/a-2642-1155","url":null,"abstract":"<p><strong>Objectives: </strong>Endoscopic endonasal surgery for skull base tumors has advanced significantly, but postoperative cerebrospinal fluid (CSF) leak remains a significant concern. Introducing the vascularized pedicled nasoseptal flap (PNSF) has markedly reduced CSF leak rates, though outcomes remain variable across different studies. This systematic review and meta-analysis aimed to compare the efficacy of vascularized versus nonvascularized reconstruction techniques in these procedures.</p><p><strong>Design: </strong>Three databases (PubMed, Cochrane, and Embase) were systematically searched to identify studies comparing CSF leak rates between PNSF and nonvascularized techniques for reconstruction after endoscopic endonasal skull base surgeries. It was designed according to the preferred reporting items for systematic reviews and meta-analyses reporting guidelines. Statistical analysis was performed using Review Manager, with heterogeneity evaluated via the <i>I</i> ² statistic.</p><p><strong>Results: </strong>After thorough selection, twenty articles were selected, and a total of 4,088 patients were included, of whom 1,851 were assigned to the nasoseptal flap group, and 2,237 were assigned to the no-flap group. The postoperative CSF leak ratio was significantly lower in the group that underwent reconstruction with PNSF compared with all the other grouped methods, respectively, 3.4 and 5.6% (odds ratio [OR]: 0.48; 95% confidence interval [CI]: 0.34-0.66; <i>p</i>  < 0.00001; <i>I</i> ²  = 54%).</p><p><strong>Conclusion: </strong>Our results suggest that using the PNSF is associated with a lower incidence of postoperative CSF leak than other reconstruction techniques in endoscopic skull base surgeries and may be used for patients at risk of this complication.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"469-476"},"PeriodicalIF":0.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391027","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":"Geographic Trends and Disparities in Meningioma Mortality: A National Observational Study from 1999 to 2020 Utilizing the CDC Wonder Database.","authors":"Jaskeerat Gujral, Om H Gandhi, Jang W Yoon, Ali K Ozturk, William C Welch, Mert M Dagli","doi":"10.1055/a-2642-0933","DOIUrl":"10.1055/a-2642-0933","url":null,"abstract":"<p><strong>Background: </strong>Meningiomas are benign tumors that surround the brain and spinal cord. While studies have examined disparities in meningioma outcomes nationally, the meningioma mortality rate based on urbanization level is unclear. This study utilized the Centers for Disease Control Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database to investigate meningioma mortality rates and disparities between urbanization categories.</p><p><strong>Methods: </strong>Patients whose underlying cause of death was meningioma from 1999 to 2020 were included. Chi-squared testing determined mortality differences across urbanization groups (large central metro, large fringe metro, and medium metro). Multivariable logistic regression and adjusted odds ratios (OR) evaluated associations between death location and age, sex, race, and ethnicity. Age-adjusted meningioma mortality rates per 100,000 people with 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>We analyzed a cohort of 12,274 patients. All older age groups demonstrated significantly lower odds of mortality in large central metros compared with other regions (OR: 0.54-0.69; <i>p</i>  < 0.05). Men had higher odds of dying in large central metro areas compared with women (OR: 1.09; <i>p</i>  = 0.047). Asian and African American patients had significantly higher odds of meningioma mortality in large central metros compared with their counterparts (OR: 7.53 vs. 3.42; <i>p</i>  < 0.001). Similarly, Hispanic/Latino ethnicity was associated with an increased likelihood of death in large central metros (OR: 6.97; <i>p</i>  < 0.001), but a lower likelihood in medium metros (OR: 0.77; <i>p</i>  = 0.029). No significant changes in mortality rates were observed based on urbanization.</p><p><strong>Conclusion: </strong>We report that urbanization plays a significant role in meningioma mortality, with varying effects by sex, race, ethnicity, and age.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"448-455"},"PeriodicalIF":0.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391313","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":"Clinical and Radiological Response Following Single-Session Gamma Knife Radiosurgery in Glomus Jugulare Tumors.","authors":"Aprajita Chaturvedi, Nishanth Sadashiva, Arun Thimmarayappa, Divisha Nagpal, Sushrut Baligar, Subhas Konar, Manish Beniwal, Andiperumal R Prabhuraj, Vikas Vazhayil, Arivazhagan Arimappamagan","doi":"10.1055/a-2640-3710","DOIUrl":"10.1055/a-2640-3710","url":null,"abstract":"<p><strong>Introduction: </strong>Glomus tumors are rare, slow-growing, hypervascular skull base tumors and frequently involve critical neurovascular structures. Surgical resection is technically challenging and is associated with high morbidity rates due to lower cranial nerve injury and CSF leak. Gamma knife radiosurgery (GKRS) has revolutionised the management of these lesions with high clinical and tumor control rates and a low side effect profile. In this study, we have attempted to study the tumor and clinical control rate along with the prediction factors.</p><p><strong>Methods: </strong>This is a retrospective data review of all patients with glomus jugulare tumors from 2010 to 2023 who underwent GKRS in our center. Clinical, neuroimaging, and radiosurgical treatment were re-reviewed, and all patients' prognostic factors for clinical and tumor control were analyzed.</p><p><strong>Results: </strong>The study included 95 patients. The median age was 45 years, with three-fourths of our patients being female, 69 (72.6%). Hearing loss was the most common symptom. The median marginal dose at the 50% isodose line was 16 Gy. The mean tumor volume was 8.7 cc, and the mean treatment volume was 8.3 cc. The tumor control rate in our study period was 96.9%. Younger age and Glasscock-Jackson type 1 were found to be worse and a good prognostic factor, respectively. The clinical control rate in our study was 93.9%, with no related significant prognostic variable in our study.</p><p><strong>Conclusion: </strong>Gamma knife is a safe and effective treatment option for these formidable tumors with a very low complication rate.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 3","pages":"276-286"},"PeriodicalIF":0.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839095","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":"Comprehensive Genomic Profiling of Sinonasal Carcinomas: Identification of Common Mutations and Potential Targets for Therapy.","authors":"Gabriel Bitar, Beau Hsia, Saif Alshaka, Bastien A Valencia, Jeeho Kim, Mariko Sato, John Crawford, Michael L Levy, Sean Polster, Vijay A Patel","doi":"10.1055/a-2639-5790","DOIUrl":"10.1055/a-2639-5790","url":null,"abstract":"<p><strong>Objective: </strong>Sinonasal cancers are malignant neoplasms arising from the nasal cavity and paranasal sinuses, including squamous cell carcinoma (SCC), adenocarcinoma, and undifferentiated carcinoma. Due to their rarity, comprehensive genomic data remain limited. Treatments include surgery, radiation, and chemotherapy, with ongoing trials investigating agents like cetuximab, cisplatin, and Tazemetostat.</p><p><strong>Materials and methods: </strong>We analyzed sinonasal cancer cases from the American Association for Cancer Research (AACR) Project Genomics Evidence Neoplasia Information Exchange (GENIE) database via cBioPortal (v16.1-public, accessed July 22, 2024). Common gene mutations, correlations, and mutual exclusivities were assessed using statistical analyses with false discovery rate correction.</p><p><strong>Results: </strong>Of 2,595 head and neck cancer samples, 122 (4.7%) were sinonasal carcinoma: 70 (57.4%) SCC, 31 (25.4%) undifferentiated carcinoma, and 21 (17.2%) adenocarcinomas. The most frequent mutations were TP53 (tumor protein 53; 40%), PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha; 14%), KMT2D (lysine methyltransferase 2D; 11%), and CDKN2A (cyclin-dependent kinase inhibitor 2A; 9%). Subtype-specific mutations included IDH2 (isocitrate dehydrogenase; 230%) in undifferentiated carcinoma and FAT1 (15%) in adenocarcinoma. TP53 frequently co-occurred with PRKDC (protein kinase, DNA-activated, catalytic subunit; <i>p</i>  = 0.020), while KMT2D co-occurred with PIK3CA ( <i>p</i>  = 0.018).</p><p><strong>Conclusion: </strong>TP53, PIK3CA, and KMT2D mutations are prevalent in sinonasal carcinoma, highlighting potential targets for therapy. Tazemetostat, targeting KMT2D-related DNA (deoxyribonucleic acid) methylation, and cetuximab, targeting the PIK3CA signaling cascade, may offer therapeutic benefits. Further research on mutation-specific therapies could improve treatment strategies.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 3","pages":"337-344"},"PeriodicalIF":0.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839073","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":"Medically Refractory Trigeminal Neuralgia: A Comparative Study of Outcomes of Microvascular Decompression versus Gamma Knife Radiosurgery and Percutaneous Radiofrequency Ablation.","authors":"Kevin J Sudevan, Madhusudhan Nagesh, Andiperumal R Prabhuraj, Nupur Pruthi, Preetham Dange, Sattar Khan, Manish Beniwal, Nishanth Sadashiva, Vikas Vazhayil, Subhas Konar, Arivazhagan Arimappamagan","doi":"10.1055/a-2639-5914","DOIUrl":"10.1055/a-2639-5914","url":null,"abstract":"<p><strong>Objective: </strong>The surgical options for medically refractory trigeminal neuralgia (TN) are diverse, with limited comparative evidence. This study evaluates and compares pain-free period and time to recurrence for patients who underwent microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and radiofrequency ablation (RFA).</p><p><strong>Methods: </strong>A retrospective review of patients with medically refractory TN over a 10-year period from 2009 to 2018 at a tertiary neurosurgical center was performed. Patients with at least 1 year of follow-up after the treatment procedure were included. Clinical details, radiological records, intraoperative findings, and treatment details of radiosurgery and ablative procedures were recorded.</p><p><strong>Results: </strong>A total of 189 patients were included, the mean age being 52.54 (± 13.3) years, with a male:female ratio of 1.52:1. The mean duration of symptoms was 70.19 (± 57.6) months, with 86.3% of patients presenting with type 1 neuralgia. The median follow-up duration was 84, 100, and 67 months for MVD, GKRS, and RFA, respectively. The percentages of patients with favorable outcomes (Barrow Neurological Institute Pain Intensity Score [BNI I-IIIa]) were 87.8, 67.3, and 66.5%, respectively, for MVD, GKRS, and RFA. The median pain-free intervals were 65, 59, and 36 months, with recurrence rates of 24.2, 25, and 40.5% for MVD, GKRS, and RFA, respectively.</p><p><strong>Conclusion: </strong>This study reaffirms MVD as the best first-line treatment for medically refractory TN, with GKRS being a useful alternative in patients who are surgically unfit or unwilling, and an optimum second-line treatment for those with recurrences. RFA is useful as an adjunct in patients unfit for surgery, with a high initial efficacy albeit with high recurrence rates.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 3","pages":"268-275"},"PeriodicalIF":0.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839060","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":"Molecular Profiling of Olfactory Neuroblastoma Using the AACR Project GENIE Database.","authors":"Beau Hsia, Roshan Dongre, Aya Erquizi, Paula V Guerra-Navarro, Gabriel Bitar, Saif A Alshaka, Jeeho D Kim, Bastien A Valencia-Sanchez, Michael G Brandel, Mariko Sato, John R Crawford, Michael L Levy, Vijay A Patel, Sean P Polster","doi":"10.1055/a-2639-5690","DOIUrl":"10.1055/a-2639-5690","url":null,"abstract":"<p><strong>Objective: </strong>Olfactory neuroblastoma (ONB) is a rare head and neck cancer arising from the upper nasal cavity, with limited systemic therapeutic options due to a poor understanding of its genomic landscape. This study aims to utilize a patient-level genomic repository to identify potential therapeutic targets and improve disease modeling in ONB.</p><p><strong>Design: </strong>Retrospective genomic analysis.</p><p><strong>Setting: </strong>Data analysis was performed using the American Association for Cancer Research (AACR) Project Genomics Evidence Neoplasia Information Exchange (GENIE) database.</p><p><strong>Participants: </strong>Patients with confirmed ONB who have undergone targeted sequencing within GENIE.</p><p><strong>Main outcomes measures: </strong>Data were analyzed for recurrent somatic mutations, along with their clinical and demographic correlations, with significance set at <i>p</i>  < 0.05.</p><p><strong>Results: </strong>A high prevalence of mutations in TP53 (tumor protein p53) and FRK (fibroblast growth factor receptor kinase) genes was identified. A moderate prevalence of mutations in NOTCH3 (notch receptor 3), SMARCA4 (SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily A, member 4), RET (rearranged during transfection), and CTCF (CCCTC-binding factor) was also identified. The mutation patterns differed between pediatric and adult ONB cases. Specific mutations were enriched in metastatic tumors compared with primary tumors.</p><p><strong>Conclusion: </strong>This study provides a genomic profile for ONB, identifying key mutations and potential therapeutic targets. The identification of frequently mutated genes like TP53 and FRK suggests potential targets for novel therapies. The observation that certain genes are mutated in pediatric ONB but not adult ONB (and vice versa), and the presence of specific mutations in metastatic tumors that are absent in primary tumors, offers valuable insights for future precision medicine and the design of targeted therapeutic interventions for these distinct clinical presentations.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 3","pages":"330-336"},"PeriodicalIF":0.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839050","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":"Endoscopic Endonasal Dacryocystectomy for Tumors Involving the Nasolacrimal Duct and Lacrimal Sac.","authors":"Lifeng Li, Weiwei Wang, Nyall R London, Tianhua Yi, Yonggang Jin, Xiahong Chen","doi":"10.1055/a-2627-3969","DOIUrl":"10.1055/a-2627-3969","url":null,"abstract":"<p><strong>Purpose: </strong>Endoscopic endonasal dacryocystorhinostomy is performed to treat epiphora in patients with chronic dacryocystitis. However, the potential application of an endonasal dacryocystectomy for malignancies involving the lacrimal system (lacrimal sac and nasolacrimal duct) has not been sufficiently investigated. This study aims to assess the feasibility of an endonasal dacryocystectomy and to investigate its efficacy with clinical case scenarios.</p><p><strong>Materials and methods: </strong>An endoscopic endonasal dacryocystectomy was conducted on two cadaveric specimens (four sides). An endonasal dacryocystectomy for tumors involving the lacrimal system was performed in six patients. The feasibility of performing an endonasal dacryocystectomy was assessed on cadaveric dissection, and the efficacy of endonasal dacryocystectomy for patients with involvement of the lacrimal system was evaluated.</p><p><strong>Results: </strong>Endonasal extirpation of the lacrimal system was feasible on four cadaveric sides. For five patients with sinonasal malignancies (two adenoid cystic carcinoma, one squamous cell carcinoma, two mucosal melanoma) and one with lacrimal sac melanoma, endonasal dacryocystectomy was successfully performed and negative margins achieved in all six patients. One patient harbored postoperative epiphora, no other comorbidities were detected. With an average follow-up of 18 months, no regional recurrence at the lacrimal system was detected.</p><p><strong>Conclusion: </strong>To perform an endoscopic endonasal dacryocystectomy is feasible on cadaveric specimens. For sinonasal malignancies secondary involving the lacrimal system, it is possible to conduct an endonasal resection when the indication is appropriately selected.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 3","pages":"e95-e100"},"PeriodicalIF":0.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839065","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 Legacy and Long-Term Impact of Dr. Albert L. Rhoton Jr.: Contributions of Rhoton Fellows to the Field of Neurosurgery.","authors":"Beste Gülsuna, Megan M J Bauman, Baylee Stevens, Maria D Astudillo Potes, Charlotte E Michaelcheck, Michael J Link, Maria Peris Celda, Christopher S Graffeo","doi":"10.1055/a-2627-3912","DOIUrl":"10.1055/a-2627-3912","url":null,"abstract":"<p><strong>Background: </strong>Professor Albert J. Rhoton Jr., MD, is renowned for his groundbreaking dissections, marking a monumental achievement in the field of neuroanatomy. Alongside his anatomical contributions, he also passed on his knowledge and skills to numerous fellows, leaving behind a profound legacy. Despite the widespread recognition of his influence, little quantitative work has been done to characterize the scholarly impact of his alumni.</p><p><strong>Methods: </strong>Data were collected on Rhoton fellows, including fellowship years, country of origin, current institutions, and titles, practice settings, and leadership roles. Scholarly productivity was evaluated by assessing publication counts, including publications before and after the fellowship, and publications focused on surgical anatomy. Additionally, H-indices and citation counts were recorded. Other variables analyzed included ownership of a surgical anatomy laboratory, and participation in organizing hands-on courses.</p><p><strong>Results: </strong>We analyzed 118 alumni from diverse countries. There was a significant increase in publication output following the fellowship, with publications rising from an average of 7 to 76 ( <i>p</i>  < 0.001). Fellows from high-income countries had higher research productivity than those from middle-income countries, with greater average H-index ( <i>p</i>  = 0.003), publication count ( <i>p</i>  = 0.01), and citation score ( <i>p</i>  = 0.003). Overall, 65% of fellows pursued academic practice, with 18% owning a laboratory and 30% involved in hands-on courses.</p><p><strong>Conclusion: </strong>Dr. Rhoton's mentorship has shaped a generation of neurosurgeons who continue his legacy. His fellows have established careers worldwide, leading in academia, professional organizations, and surgical training. Their global impact underscores the lasting value of structured mentorship in neurosurgery.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 3","pages":"247-255"},"PeriodicalIF":0.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839219","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}