Neurosurgical focus最新文献

{"title":"Letter to the Editor. Neuroimaging assessment of Hoffmann's sign in CSM patients.","authors":"Lonnie Smith, Ali F Khan, Zachary A Smith","doi":"10.3171/2024.7.FOCUS24414","DOIUrl":"https://doi.org/10.3171/2024.7.FOCUS24414","url":null,"abstract":"","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E10"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniosynostosis as a cause of intracranial hypertension in Alagille syndrome: a case series of 6 consecutive pediatric patients.","authors":"Lelio Guida, Antoine Gardin, Syril James, Eric Arnaud, Capucine Toujouse, Julia Roux, Emmanuel Barreau, Maya Benali Abdallah, Marion Almes, Luca Sartori, Konstantina Kavoura, Oanez Ackermann, Emmanuel Gonzales, Emmanuel Jacquemin, Roman Hossein Khonsari, Giovanna Paternoster","doi":"10.3171/2024.10.FOCUS24588","DOIUrl":"10.3171/2024.10.FOCUS24588","url":null,"abstract":"<p><strong>Objective: </strong>Craniosynostoses are an underrecognized cause of intracranial hypertension (ICH), especially when associated with congenital syndromes. Alagille syndrome (ALGS) is a multisystem disorder with typical facial features and hepatobiliary, cardiac, vascular, skeletal, and ocular manifestations. The occurrence of craniosynostosis in ALGS is rare and can be associated with chronic ICH, requiring craniofacial surgery to increase the intracranial volume. The authors report a series of 6 patients with ALGS with craniosynostosis and discuss their neurosurgical management.</p><p><strong>Methods: </strong>The authors included all patients with ALGS and craniosynostosis assessed in their national reference center between 2012 and 2024. They collected the following parameters: date of birth; sex; JAG1 mutation; hepatobiliary, cardiac, vascular, skeletal and ocular symptoms; type of craniosynostosis; presence of papilledema; head circumference; type of surgery (if needed); and clinical outcome.</p><p><strong>Results: </strong>The 6 patients had a median age of 6 years at referral (range 15 months-6 years). Four patients presented with a history of ICH and papilledema. Craniofacial CT scans showed the fusion of all sutures (coronal, sagittal, and lambdoid) in 2 patients; bicoronal plus bilambdoid synostosis in 1 patient; and sagittal plus bilambdoid synostosis 1 patient. All patients required biparietal floating craniotomies, leading to prompt improvement of papilledema. Two patients without a history of ICH presented with single-suture synostosis without papilledema (anterior plagiocephaly and scaphocephaly).</p><p><strong>Conclusions: </strong>The authors report single-suture and multisuture craniosynostosis associated with ALGS and its association with chronic ICH. They suggest systematic screening for craniosynostosis in patients with ALGS and papilledema to avoid unrecognized chronic ICH.</p>","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E6"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction. Ongoing challenges in pediatric craniofacial surgery.","authors":"John R W Kestle, Jay Riva-Cambrin, Christopher M Bonfield, Amy Lee, Jennifer M Strahle","doi":"10.3171/2024.10.FOCUS24599","DOIUrl":"https://doi.org/10.3171/2024.10.FOCUS24599","url":null,"abstract":"","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E1"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sports after single-suture synostosis surgery: a survey of Synostosis Research Group members.","authors":"Christopher M Bonfield, Allyson L Alexander, Craig B Birgfeld, Daniel E Couture, Lisa R David, Brooke French, Barbu Gociman, Jesse A Goldstein, Michael S Golinko, John R W Kestle, Amy Lee, Suresh N Magge, Ian F Pollack, S Alex Rottgers, Christopher M Runyan, Matthew D Smyth, Raj Vyas, C Corbett Wilkinson, Gary B Skolnick, Kamlesh B Patel, Jennifer M Strahle","doi":"10.3171/2024.10.FOCUS24569","DOIUrl":"https://doi.org/10.3171/2024.10.FOCUS24569","url":null,"abstract":"<p><strong>Objective: </strong>Patients with a history of surgery for single-suture craniosynostosis (SSC) as an infant often wish to participate in sports later in childhood. However, there are no established guidelines from neurosurgeons and craniofacial surgeons to guide parents in which sports their child should or should not participate. Therefore, this study aimed to evaluate the attitudes and practice patterns of experienced neurosurgeons and craniofacial surgeons regarding the counseling of caregivers of these patients about sports participation.</p><p><strong>Methods: </strong>A survey was administered to neurosurgeons and craniofacial plastic surgeons of the Synostosis Research Group (SynRG), a group of 9 North American institutions, to identify attitudes toward sports participation in patients with past SSC surgery. Survey responses were collected anonymously in REDCap. Questions regarding specific sports participation recommendations for patients who underwent surgery as an infant for SSC with ideal healing and for those who required a delayed cranioplasty were answered. Questions pertained to patients with nonsyndromic SSC without associated Chiari malformation, syrinx, or other intracranial/intraspinal anomalies.</p><p><strong>Results: </strong>Overall, 20 surgeons were invited to participate in the survey, with 18 (90%) (9 neurosurgeons and 9 craniofacial plastic surgeons) fully completing it. Only 1 (5.6%) surgeon counseled against any sports participation for patients with ideal healing. If cranioplasty was required, 39%-50% of surgeons counseled against some participation (most commonly restricting football/rugby, boxing, ice hockey, lacrosse, and wrestling), depending on the extent of the cranioplasty. Overall, more plastic surgeons (56%-67%) counseled against sports participation (including lower-contact sports such as baseball/softball, basketball, gymnastics, and soccer) than neurosurgeons (22%-33%) in patients who required cranioplasty.</p><p><strong>Conclusions: </strong>SynRG surgeons generally did not counsel against sports participation (including contact sports) for children with a history of SSC surgery as an infant who had ideal healing. In patients requiring cranioplasty, 39%-50% of surgeons recommended against high-contact sports participation.</p>","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E3"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eleven years of experience with endoscopic and open surgery for craniosynostosis and risk factors for undesirable outcome.","authors":"Mohammad Amin Dabbagh Ohadi, Seyed Farzad Maroufi, Mohammadsadegh Talebi Kahdouei, Keyvan Tayebi Meybodi, Fatemeh Mirashrafhi, Farideh Nejat, Hojjat Zeraati, Zohreh Habibi","doi":"10.3171/2024.10.FOCUS24587","DOIUrl":"https://doi.org/10.3171/2024.10.FOCUS24587","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study reports the authors' experience with surgical interventions for nonsyndromic craniosynostosis. They assessed open surgery and minimally invasive endoscopic suturectomy in terms of periprocedural outcomes and related risk factors for postoperative complications and reoperation. This study aimed to provide insights toward surgical approach decisions and lay the groundwork for future prospective studies in this field.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort study, the medical records of all patients with nonsyndromic craniosynostosis who underwent primary surgery at the authors' center from 2014 to 2024 were analyzed. The authors assessed open surgery and endoscopic suturectomy based on anesthesia time, length of hospitalization, hematological parameters, postoperative blood transfusion volume, and changes in head circumference percentile (HCP). A subgroup analysis was conducted for patients younger than 6 months across different types of craniosynostosis. Further investigation was conducted to identify potential risk factors for postoperative complications and reoperation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 633 pediatric patients treated for nonsyndromic craniosynostosis were included in this study (281 with endoscopic suturectomy, 352 with open surgery). These data indicated a growing trend for endoscopic procedures. The authors' center began performing endoscopic surgery in 2014, and by 2024, 75% of craniosynostosis patients underwent this procedure (p &lt; 0.001). Patients in the endoscopic group experienced shorter anesthesia times (p &lt; 0.001), reduced lengths of hospitalization (p &lt; 0.001), and lower blood transfusion volumes (p &lt; 0.001) compared with those in the open surgery group; however, blood transfusion volume differences were not significant in the subgroup analysis. The subgroup analysis revealed comparable HCP changes in sagittal (p = 0.4) and coronal (p = 0.85) craniosynostosis. In comparison, greater changes were noted after open surgery in cases of metopic (p = 0.03) and multisuture (p = 0.04) craniosynostosis. The rates of postoperative complications (endoscopic 6.4% and open 4.5%) and reoperation (endoscopic 4.6% and open 2.8%) were comparable between the two groups. In univariate analysis, higher weight (OR 1.07, p &lt; 0.05) was identified as the only risk factor for postoperative complications, which can be attributed to delayed surgical intervention. Coronal (OR 8.38, p &lt; 0.05) and multisuture (OR 23.66, p &lt; 0.01) craniosynostoses were associated with higher reoperation rates, while adding barrel stave osteotomies was linked to a lower reoperation rate (OR 0.22, p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Endoscopic suturectomy is associated with acceptable periprocedural outcomes compared with open surgery, with comparable rates of complications and reoperation. These findings are supported by the subgroup analysis. However, further studies focusing on cran","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E5"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photogrammetric evaluation of extended midline strip craniectomy with bilateral parietal osteotomies on frontal morphology in patients with isolated sagittal synostosis.","authors":"Thomas Rückschloß, Sven Zittel, Elhassan Hassanein, Ahmed El Damaty, Sandro M Krieg, Oliver Ristow, Jürgen Hoffmann, Michael Engel","doi":"10.3171/2024.10.FOCUS24582","DOIUrl":"https://doi.org/10.3171/2024.10.FOCUS24582","url":null,"abstract":"<p><strong>Objective: </strong>Isolated craniosynostosis of the sagittal suture results in scaphocephaly characterized by a long, narrow skull. Surgical correction of this condition remains debated, particularly regarding the necessity of directly addressing frontal bossing. This study aimed to assess the effectiveness of extended strip craniectomy combined with bilateral barrel staving in improving cranial morphology without direct intervention on the forehead.</p><p><strong>Methods: </strong>This retrospective study included 81 patients diagnosed with isolated sagittal synostosis, treated surgically at an average age of 5.3 months. Three-dimensional photogrammetric scans were obtained 1 day before surgery and 14 days, 3 months, and 12 months postoperatively. The bossing angle, nasofrontal angle, cephalic index, and vertex ratio were analyzed. A control group of age-matched healthy children was used for comparison.</p><p><strong>Results: </strong>Significant reductions in the bossing angle were observed from preoperatively to 12 months postoperatively, indicating that the intervention contributed to a more normalized cranial shape. The cephalic index increased significantly postoperatively, although it remained lower than that of the control group. The nasofrontal angle remained stable across all time points, with minimal differences between the study and control groups. The vertex ratio decreased significantly over time, suggesting a balanced cranial shape. However, persistent differences between the study and control groups suggest that the intervention did not fully normalize cranial morphology in the short to midterm.</p><p><strong>Conclusions: </strong>Extended strip craniectomy with bilateral barrel staving, while effective in improving certain aspects of cranial morphology, may not fully equalize cranial shape within the short to midterm. The use of 3D photogrammetry as a noninvasive method for assessing cranial changes is validated in this study and holds promise for broader applications in craniofacial surgery.</p>","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E7"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low- and middle-income country perspective: bridging gaps in craniofacial surgery care. Challenges, innovations, and future prospects.","authors":"Aiman Waheed, Mayank Jha, Bipin Chaurasia","doi":"10.3171/2024.10.FOCUS24486","DOIUrl":"https://doi.org/10.3171/2024.10.FOCUS24486","url":null,"abstract":"","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E9"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of craniofacial cleft and orbital hypertelorism: a single-center cohort study.","authors":"Kamran As'adi, Sayedali Ahmadi, Marjan Mirsalehi","doi":"10.3171/2024.10.FOCUS24573","DOIUrl":"https://doi.org/10.3171/2024.10.FOCUS24573","url":null,"abstract":"<p><strong>Objective: </strong>Craniofacial clefts, characterized by congenital disruptions in the development of facial and cranial tissues, often present alongside orbital hypertelorism (ORH), an abnormal increase in the interorbital distance. These conditions pose significant challenges in craniofacial surgery due to the complex anatomical and functional considerations involved. This single-center cohort study retrospectively analyzed 22 patients diagnosed with craniofacial cleft syndromes and ORH who were treated at the Craniofacial Centre, Fatima Plastic and Reconstructive Surgery Hospital between July 2016 and October 2023.</p><p><strong>Methods: </strong>This study outlines the preoperative evaluations, surgical interventions, and postoperative outcomes of these cases. Surgical techniques varied according to the severity and type of deformity, guided by Tessier's classification system. Procedures included spectacle osteotomy, box osteotomy, and facial bipartition osteotomy, with each approach tailored to address the unique anatomical challenges presented by ORH and associated craniofacial anomalies.</p><p><strong>Results: </strong>There was a 9% incidence of postoperative infections and a 22.7% incidence of CSF leakage, with a subset of these leading to meningitis. These complications underscore the complexity of managing craniofacial clefts and ORH, highlighting the necessity for meticulous surgical planning and postoperative care.</p><p><strong>Conclusions: </strong>Despite the challenges, the study demonstrates that individualized, protocol-driven surgical interventions can achieve significant aesthetic and functional improvements in patients with these congenital anomalies.</p>","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E4"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniosynostosis surgery practice patterns in the United States: what are we doing and how are we doing it?","authors":"Lauren E Sullivan, Alexandra Alving-Trinh, Nicholas O'Sick, Alexander Nixon, Christopher M Bonfield, Michael S Golinko, Matthew E Pontell","doi":"10.3171/2024.10.FOCUS24572","DOIUrl":"https://doi.org/10.3171/2024.10.FOCUS24572","url":null,"abstract":"<p><strong>Objective: </strong>The surgical management of craniosynostosis varies without consensus on technique or standard outcomes reporting. The authors of this study aimed to investigate current surgical management of craniosynostosis in the United States.</p><p><strong>Methods: </strong>Two hundred seventy-five surgeons actively treating craniosynostosis in the United States were surveyed. The results from a 28-item instrument were analyzed according to surgeon specialty, surgeon tenure, and geographic location of practice.</p><p><strong>Results: </strong>The overall response rate was 47.6% (131/275), and final analyses included 58 plastic and reconstructive surgeons and 69 neurosurgeons from 79 different institutions. The majority of surgeons used internal data registries (65.4%); however, only 17.4% of neurosurgeons and 34.5% of plastic surgeons (p = 0.04) contributed to national or international registries. Neurosurgeons were more likely to offer endoscopic strip craniectomy for unicoronal craniosynostosis (75.4% vs 50.0%, p = 0.05) and unilateral lambdoid craniosynostosis (69.6% vs 48.3%, p = 0.018). Plastic surgeons were more likely to offer spring-assisted cranioplasty for bilambdoid synostosis (20.7% vs 7.2%, p = 0.036) and most other sutures. For all sutures, open cranial vault remodeling remains the most frequently offered technique. Plastic surgeons more often selected the surgical technique based on physical examination (86.2% vs 68.1%, p = 0.02) and recognized a \"gold-standard\" treatment (51.7% vs 17.4%, p < 0.001). Region did not significantly impact the techniques offered. Compared to surgeons with fewer years of experience, those with 6 or more years of experience were less likely to offer cranial vault remodeling for unilateral lambdoid craniosynostosis (p = 0.002) and those with more than 10 years of experience were less likely to offer cranial vault remodeling for bilateral lambdoid craniosynostosis (p = 0.011).</p><p><strong>Conclusions: </strong>The authors present the largest description of current craniosynostosis practices in the United States. Reported surgical offerings were overall similar across specialties, regions, and years of surgeon experience. Nearly all surveyed surgeons continue to offer open cranial vault remodeling as an option for all included craniosynostosis variations. Endoscopic strip craniectomy is the second most proposed technique for most sutures, but distraction methods are similarly or more frequently offered in cases of bilateral and multisuture synostoses. Plastic surgeons also report greater spring-assisted repair offers than neurosurgeons, whereas the longest practicing surgeons are less likely to offer open repair in lambdoid cases. Encouraging further contributions to national databases, such as that of the Synostosis Research Group, may provide robust outcome data that can help to identify best practices for managing this complicated pathology.</p>","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"58 1","pages":"E2"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design, fabrication, and testing of a new soft-pouch robot with 6 degrees of freedom to expand the reach of open and endonasal skull base approaches.","authors":"Yifan You, Chen Dai, Shunheng Xin, Daniel Quintana, Wesley Shoap, Ronald S Fearing, Ezequiel Goldschmidt","doi":"10.3171/2024.9.FOCUS24540","DOIUrl":"10.3171/2024.9.FOCUS24540","url":null,"abstract":"<p><strong>Objective: </strong>Most robots currently used in neurosurgery aid surgeons in placing spinal hardware and guiding electrodes and biopsy probes toward brain targets. These robots are inflexible, cannot turn corners, and exert excessive force when dissecting and retracting brain tissue, limiting their applicability in cranial base surgery. In this study, the authors present a novel soft-pouch robot prototype driven by compressed air and capable of gentle tissue manipulation. The robot is manufactured with technology developed by the authors, with multiple bidirectional bending points and a miniature camera running through the robot's central channel.</p><p><strong>Methods: </strong>A soft, pneumatically driven pouch manipulator was created using a novel rapid and scalable system (integrated multilayer pouch robots with inkjet-patterned thin films). Made from 4 layers of thin, low-density polyethylene films, the manipulator has a thin deflated profile (152 µm) and contains 5 independent bidirectional joints with 50° range in each direction, as well as a wrapping end-effector. The robot carries a camera through its central channel. Four cadaveric models were used to demonstrate the robotic prototype being maneuvered inside different anatomical structures during simulated endonasal and posterior fossa approaches, with a manually positioned robot base and manually controlled air pressures.</p><p><strong>Results: </strong>The robot is a pneumatically driven, soft-continuum manipulator with 12 control inputs and 6 independently controllable degrees of freedom. This design enables in-plane obstacle avoidance and orientation control. The robot is trapezoidal-shaped, with a total weight of 0.4 g, a 10-mm-wide distal end, and a length of 138 mm. The variable production cost (materials cost) of the manipulator is approximately $1. The manipulator is maneuvered to enter the maxillary sinus and through the endonasal corridor, demonstrating its potential use for anterior skull base approaches. It is also successfully maneuvered around the pons in a simulated retrosigmoid approach.</p><p><strong>Conclusions: </strong>This robot offers a promising solution for safely maneuvering through narrow surgical windows encountered during skull base approaches. The multiple bending points of the robot, combined with its passive deformation capacity, allow it to turn around immovable structures, expanding the reach of surgical openings. The cost-effectiveness, rapid production, and scalability of the robot represent additional advantages.</p>","PeriodicalId":19187,"journal":{"name":"Neurosurgical focus","volume":"57 6","pages":"E7"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}