Neurocirugia (English Edition)最新文献

{"title":"Measures to prevent surgical site infections in neurosurgery: Survey and comparative analysis.","authors":"Cristina Sánchez-Viguera, Josep M Badia","doi":"10.1016/j.neucie.2025.500678","DOIUrl":"10.1016/j.neucie.2025.500678","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infections (SSI) are among the most common type of healthcare-associated infections and are involved with an increase in morbidity, mortality and higher healthcare costs.</p><p><strong>Methods: </strong>The Observatory of Infection in Surgery has conducted a survey to assess the level of awareness and implementation of the preventive measures for SSI. A 64-question questionnaire was given to SENEC (Sociedad Española de Neurocirugía) members.</p><p><strong>Results: </strong>The survey was answered by 123 neurosurgeons. There is a gap between clinical guidelines and neurosurgery practice (67%), even though neurosurgeons place a high value on international (81.7%) or national (78.7%) clinical guidelines. There are still practices not supported by scientific evidence that some of our respondents follow, including antibiotic prophylaxis≥24h (10.6%), the habit of not allowing the antiseptic solution to air dry (38.2%) or the use of transparent plastic adhesive drape on the surgical field (77.4%). The most widespread practice for hair management is the selective removal from the surgical area (83.3%). It is most commonly performed by the neurosurgeon himself, in the operating room, which is a significant difference from the use of other surgical specialties (68.5% vs 3.5%, P<.001). There are only 37% of respondents who use alcohol solutions. Double-gloving is utilised by 16.7% of neurosurgeons. The usual use of drainage is quite widespread (60.7%), while the rate of nutritional assessment prior to major surgery is very low (7.5%). Only 37.2% report providing feedback on SSI rates to surgical teams, and a small 16.5% have received specific training programmes on SSI.</p><p><strong>Conclusion: </strong>Scientific evidence-supported measures are not fully incorporated into neurosurgical practice, and there is a lack of specific training in surgical infection prevention. Additionally, a specific issue has been identified, particularly regarding hair management. Neurosurgeons should actively participate in SSI prevention programmes and analyse the reasons why they do not implement certain strategies into their clinical practice.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500678"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Short-segment lumbar fusion” vs.“microsurgical bilateral decompression via unilateral approach” after removal of the spinal fixators in patients with adjacent segment disease: Clinical retrospective study","authors":"Turgut Kuytu ,&nbsp;Ahmet Karaoğlu","doi":"10.1016/j.neucie.2025.500654","DOIUrl":"10.1016/j.neucie.2025.500654","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In cases where adjacent segment disease (ASD) develops following lumbar fusion surgery, various surgical approaches can be employed. In such cases, removal of the instrumentation can positively impact lumbar pain syndrome. One frequently used method is short-segment fixation-decompression (SSFD). One of minimally invasive methods is microsurgical bilateral decompression via unilateral approach (MBDU). This study aims to determine which method is more effective and safe in cases that developed ASD following fusion surgery by comparing SSFD and MBDU after instrumentation removal.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 47 cases treated with SSFD and 29 cases treated with MBDU. The groups were analyzed for gender, age, preoperative symptom duration, duration of hospitalization, and Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) scores during the preoperative and postoperative intermittent follow-up periods.</div></div><div><h3>Results</h3><div>Duration of hospitalization was higher in the SSFD group compared to the MBDU group (p = &lt;0.001 CI = 56,42–76,24 and 22,04–25,13 respectively), mean transverse canal diameter ratio in the decompressed segment was lower in the SSFD group (p = 0,03 IC = 0,24–0,31 for SSFD y 0,40–0,47 for MBDU), and ODI indices were higher in the SSFD group in all follow-ups (p = &lt;0.001). During the follow-up period, symptomatic ASD was observed in 3 of 47 patients in the SSFD group, whereas no symptomatic ASD was observed in the MBDU group.</div></div><div><h3>Conclusion</h3><div>In selected patients who develop ASD after fusion surgery MBDU after instrumentation removal can be considered as a minimally invasive option that does not exacerbate postoperative lumbar pain syndrome or lead to the development of new ASD. To the best of our knowledge, this is the first comparison of these two techniques in literature after removal of spinal fixators in lumbar ASD cases.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500654"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed diagnosis; non-traumatic retroclival haematoma in adults, brief case report with review and evaluation of similar cases in the literature","authors":"Ali Rıza Güvercin,&nbsp;Mehmet Aktoklu,&nbsp;Mehmet Orbay Bıyık,&nbsp;Uğur Yazar","doi":"10.1016/j.neucie.2025.500664","DOIUrl":"10.1016/j.neucie.2025.500664","url":null,"abstract":"<div><div>Retroclival subdural haematomas (RSH) are a rare occurrence, accounting for 0.3% of acute extra-axial haematomas. Although typically associated with trauma, non-traumatic causes include coagulopathy, pituitary apoplexy and vascular anomalies.The presence of cases due to non-traumatic causes can present significant diagnostic challenges. This article aims to shed light on the intricacies of non-traumatic RSH by conducting a review of the literature and presenting a case study of a 74-year-old woman on anticoagulants. The primary objective is to enhance our understanding of the diagnosis and treatment of this condition, emphasising the significance of bleeding in a location that often goes unnoticed, particularly in Computed Tomography (CT) scans, with the exception of trauma. A comprehensive review of the literature revealed 28 cases of non-traumatic RSH in adults. A detailed analysis was conducted on the demographic characteristics, causes, presentations and outcomes of these cases.The mean patient age was found to be 59 years, with a slight male predominance of 57.57%. The primary causes were identified as pituitary apoplexy (39.28%) and anticoagulants (21.42%), while 25% of cases had an unknown aetiology. Spinal canal extension occurred in 10.71% of cases, which increased morbidity.The recovery rate was 92.85% and the mortality rate was 3.57%.Non-traumatic RSH is under-recognised and often missed on standard imaging.Conservative treatment is effective without spinal cord compression.Awareness is very important, especially for diagnosis and treatment.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500664"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot study to assess the safety and efficacy of human acellular dermal matrix for Chiari surgery","authors":"Pilar Teixidor-Rodríguez ,&nbsp;Ferran Brugada-Bellsolà ,&nbsp;Maria Luisa Pérez ,&nbsp;Sebastián Menéndez-Girón ,&nbsp;Jordi Busquets-Bonet ,&nbsp;Carlos Javier Domínguez-Alonso","doi":"10.1016/j.neucie.2025.500653","DOIUrl":"10.1016/j.neucie.2025.500653","url":null,"abstract":"<div><h3>Purpose</h3><div>Although there may be benefits to adult patients who have had Chiari surgery when duroplasty is indicated, there are also more risks involved. The complications derived from a non-hermetic dural closure in the posterior fossa can be significant, mainly cerebrospinal fluid (CSF) leakage, meningitis and pseudomeningocele. We explored the option of utilizing a different duroplasty that we typically utilized in order to reduce these risks. The aim of this study is to assess the safety and efficacy of two duraplasties used for Chiari malformation (ChM) surgery: Tutopatch®, and a human acellular dermal matrix (hADM). Tutopatch®, a well-known collagen membrane commonly used by our senior surgeon, and hADM, prepared by the tissue establishment and with potential properties for use as duraplasty.</div></div><div><h3>Methods</h3><div>A unicentric prospective study was designed with one group of patients treated with hADM and another group that retrospectively acquired surgical treatment with Tutopatch®. There were nineteen patients in each group. The patients in both groups were diagnosed with same pathology and were operated on by the same senior surgeon. This study was approved by the same hospital’s Medical Ethics Committee. Demographics, clinical risk factors, clinical syndrome and pre/postoperative and postoperative events after surgery were analysed. All serious adverse events (SAEs) and adverse events (AEs) after surgery were recorded.</div></div><div><h3>Results</h3><div>No differences were found between the two groups related to sex, clinical risk factors, clinical syndrome and clinical outcomes. Seven patients presented with complications, seven the Tutopatch® group (two of them requiring a new reoperation) and none in the hADM group.</div></div><div><h3>Conclusion</h3><div>This pilot study shows that hADM is a safe and effective alternative to Tutopatch® duraplasty, as although the two materials performed equally well in the surgical repair of Chiari malformation, the former showed better clinical outcomes. Future studies are needed to confirm these outcomes in larger cohorts.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500653"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Glucose/Potassium Ratio and Neutrophil/Lymphocyte Ratio in the prognosis of patients with aneurysmal subarachnoid hemorrhage","authors":"Mónica Maldonado-Luna ,&nbsp;Ana María Castaño-León ,&nbsp;Andrea Emanuela Baciu ,&nbsp;Luis Alzamora-Llull ,&nbsp;Elvira Vallés-Núñez ,&nbsp;Alfonso Lagares","doi":"10.1016/j.neucie.2025.500655","DOIUrl":"10.1016/j.neucie.2025.500655","url":null,"abstract":"<div><h3>Antecedents and objective</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity and mortality. Traditional factors strongly associated with poor outcome are neurological condition and the amount of bleeding. Inflammation is considered a relevant mechanism of brain injury after aSAH. This study aims to investigate the potential role of new laboratory indexes related to inflammation for predicting the prognosis of aSAH patients, complementing established prognostic models.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective observational study including adults admitted for aSAH at a single neurosurgery center from 2002 to 2023. Demographic data, clinical parameters, and blood test results at admission were collected. The main outcome variable was Glasgow Outcome Scale (GOS) six month post-bleeding. A second outcome variable was in-hospital mortality. Univariable analyses were performed to identify new laboratory predictors of poor prognosis. The independent association with outcome was evaluated after adjustment of traditional risk factors by logistic regression analysis. The additional value of new laboratory predictors was determined by comparison of the area under the receiver operating curve (AUROC).</div></div><div><h3>Results</h3><div>Among 542 patients with aSAH, 417 met inclusion criteria (age &gt;18 years old and complete laboratory test available upon admission with aSAH confirmed by CT angiography (CTA) or digital subtraction angiography (DSA)). Elevated glucose/potassium ratio (GKR) in the first blood test at admission was significantly associated with unfavorable outcome and in-hospital mortality according to univariate analysis. The GKR was significantly associated with a worse final prognosis (OR 1.033, 95% CI 1.008–1.040) adjusted for age, WFNS and Fisher scales, history of diabetes mellitus and kidney disease, and prior use of diuretics, oral antidiabetic medications and insulin. Additionally, the inclusion of the GKR improved the predictive accuracy of a prognostic model compared to a model including only clinical and radiological data. The neutrophil-lymphocyte ratio (NLR) was not significantly different between subgroups of patients regarding their outcome.</div></div><div><h3>Conclusion</h3><div>GKR measured in the first 24 h after aSAH may improve the discrimination of patients with higher risk of experiencing poor outcome at six month after the bleeding.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500655"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global trends in neurosurgical research: Insights from the top 100 most-cited articles","authors":"Roser Garcia-Armengol ,&nbsp;Sebastian Andres Menéndez-Girón ,&nbsp;Cristina Hostalot ,&nbsp;Ana Cristina Pérez-Balaguero ,&nbsp;Carlos Javier Dominguez ,&nbsp;Ana Rodriguez-Hernandez","doi":"10.1016/j.neucie.2025.500656","DOIUrl":"10.1016/j.neucie.2025.500656","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to identify and analyze the 100 most-cited articles in neurosurgical journals over the past 20 years.</div></div><div><h3>Methods</h3><div>The Thomson Reuters Web of Science citation index was used to analyze articles from high-impact neurosurgical journals identified via Journal Citation Reports. Data extracted included citations, citations per year, title, authors, year, country, institution, journal, study type, and thematic area. Citation analysis identified the most impactful articles. A bibliometric analysis compared trends between 2012–2022 and 2001–2011. Descriptive statistics and Pearson correlation were applied to examine the relationship between publication year and citation count. Stata V14.2 was used for statistical analysis.</div></div><div><h3>Results</h3><div>Citations for the top 100 articles ranged from 194 to 1,501. “Journal of Neurosurgery” and “Neurosurgery” published the most-cited articles, with peak productivity in 2012 and 2013. The USA was the leading country in article contributions. Neuro-oncology, especially tumor studies, was the dominant thematic field.</div></div><div><h3>Conclusions</h3><div>The bibliometric analysis highlighted a strong centralization in neurosurgical research, with most highly cited articles coming from two major journals, largely from the United States. This reveals the significant influence of a few key contributors in global neurosurgery.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500656"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr Máximo Poza y Poza","authors":"Juan F. Martínez-Lage Sánchez","doi":"10.1016/j.neucie.2025.500661","DOIUrl":"10.1016/j.neucie.2025.500661","url":null,"abstract":"","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500661"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: Central venous stenosis-induced intracranial hypertension","authors":"Santiago Cardona-Collazos ,&nbsp;Ashly Arias ,&nbsp;Sofia Torres-Figueroa ,&nbsp;Carlos Alberto Meneses ,&nbsp;Carlos Andres Varon","doi":"10.1016/j.neucie.2025.500652","DOIUrl":"10.1016/j.neucie.2025.500652","url":null,"abstract":"<div><div>Intracranial hypertension due to central venous stenosis (CVS) is an under-recognized but potentially morbid complication of central venous catheters that can have a benign course if recognized and treated early. Here we report a case of a 23-year-old woman requiring hemodialysis via right subclavian catheter who presented with an intracranial hypertension syndrome and sudden visual loss secondary to right innominate vein thrombosis that improved after angioplasty treatment. This case illustrates how CVS can alter the pressure gradient between the subarachnoid space and the cerebral venous sinuses by increasing venous pressure, affecting cerebrospinal fluid drainage. Since CVS is a common finding in patients receiving hemodialysis, intracranial hypertension due to central venous stenosis is a differential diagnosis to consider in patients of this type who present with intracranial hypertension syndrome.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500652"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The genesis of Academic Neurosurgery. Part I: The so-called “Gestational Period” and the contributions of Harvey Cushing","authors":"Ramiro D. Lobato ,&nbsp;Alfonso Lagares ,&nbsp;Pedro A. Gómez López ,&nbsp;José A.F. Alén ,&nbsp;Pedro González León ,&nbsp;Angel Pérez Núñez ,&nbsp;Beatriz Pascual","doi":"10.1016/j.neucie.2025.500671","DOIUrl":"10.1016/j.neucie.2025.500671","url":null,"abstract":"<div><div>This is the first of five papers describing the origin and evolution of the so-called Academic Neurosurgery which will appear consecutively in the journal Neurocirugía. The three firsts focuse on the emergence of the specialty in Europe and the United States and its development in the last country between the origins and the present moment, paying special attention to the foundation of the neurosurgical societies (SNS, AANS, CNS) with their respective journals and the configuration of the residency programs. The fourth analyzes the same issues in Europe and, most specifically in Spain, also from the beginnigs to the XXI century. The fifth describes the development of Academic Neurosurgery in a neurosurgical unit of one of hospitals created by the National Social Security System in the early 1970s.</div><div>The present paper describes the initiatives, difficulties and achievements of the pioneers at both sides of the Atlantic during the so called Gestational Period for creating the new and independent specialty of Neurosurgey conceived as a scientific and clínico-surgical activiy with an academic profil.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500671"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic 360° vision of the orbit: A comparative anatomical study of endonasal and transorbital approaches.","authors":"Dario Gagliano, Roberto Manfrellotti, Nikolay Lasunin, Alberto Prats-Galino, Alberto Di Somma, Joaquim Enseñat","doi":"10.1016/j.neucie.2025.500704","DOIUrl":"10.1016/j.neucie.2025.500704","url":null,"abstract":"<p><strong>Background and objective: </strong>Treatment of lesions located within and surrounding the orbit pose considerable surgical challenges, due to the presence of critical neurovascular structures in such deep, confined spaces. Historically, transcranial and craniofacial approaches have been widely used to deal with orbital pathologies. However, in recent decades we have witnessed the emergence of minimally invasive techniques to reduce morbidity and hospitalization times. Among these techniques are the endoscopic endonasal approach (EEA) and the subsequently developed endoscopic transorbital approach (ETOA). This anatomical study aims to compare and combine the surgical view offered by these two endoscopic pathways to achieve a circumferential access to the orbit.</p><p><strong>Methods: </strong>Anatomic dissections were performed at the Laboratory of Surgical NeuroAnatomy (LSNA) of the Human Anatomy and Embryology Unit, University of Barcelona (Barcelona, Spain) on five cadaveric specimens (10 sides), whose arterial and venous systems were injected with red and blue latex respectively. Dissections were made with microsurgical instruments and a surgical endoscope.</p><p><strong>Results: </strong>After careful removal of the intraorbital fat, all the extraocular muscles were exposed and dissected, as well as the optic nerve, the ophthalmic artery, and the lacrimal gland. Special emphasis was given to dissecting the nerves' course from the cavernous sinus to their muscle innervation: oculomotor and its branches, trochlear, abducent and ophthalmic nerve with its branches (frontal, nasociliary and lacrimal nerve). Each of the two endoscopic pathways provided a different perspective of the orbit and its structures. After both corridors were completed, a communication between the surgical pathways was highlighted, in a so-called connection area.</p><p><strong>Conclusions: </strong>The combination of the EEA and ETOA provides a 360° view of the orbit and its contents. The EEA offers an inferior and medial view of the orbit, through the lamina papyracea of the ethmoid in the first case and through the roof of the maxillary sinus in the latter. At the same time, the ETOA shows a lateral perspective, removing the lateral rim of the orbit, allowing great maneuverability inside the orbit and a wide visualization. This study provides a detailed overview of the surgical neuroanatomy of the orbit, which is an essential and didactic baseline in preparation for practical clinical applications. Overall, EEA and ETOA seem adequate to gain optimal exposure of the orbit and can be adapted to treat a wide range of pathologies. Yet, surgical case series are necessary to establish the true clinical value of these endoscopic approaches in orbital and peri-orbital surgery. However, the limited number of specimens analyzed (5 cadavers, 10 sides) must be acknowledged as a limitation.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500704"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}