Journal of neurosurgery
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Journal of neurosurgery · Nov 2024
Role of the endonasal endoscopic approach in intraorbital tumor surgery: insights from a single-center experience.
This study aimed to evaluate the effectiveness of the endoscopic endonasal approach (EEA) in the surgical management of intraorbital tumors and analyze the adjunctive role of the transorbital approach (TOA) and extended modified medial maxillectomy (EMMM) in addressing anatomically complex tumors. ⋯ The combination of EEA with TOA and EMMM provides a comprehensive and adaptable surgical strategy for intraorbital tumors, accommodating various lesion locations and complexities. This combined approach not only facilitates extensive tumor resection but also maximizes the preservation of ocular function and cosmetic outcomes. The favorable results of this study support the use of a multidisciplinary surgical approach and highlight the potential for improved patient outcomes with the continued development of endoscopic techniques. Further research with a larger cohort is essential to validate these findings and establish guidelines for the combined use of these surgical methods.
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Journal of neurosurgery · Nov 2024
ReviewArtificial intelligence as a modality to enhance the readability of neurosurgical literature for patients.
In this study the authors assessed the ability of Chat Generative Pretrained Transformer (ChatGPT) 3.5 and ChatGPT4 to generate readable and accurate summaries of published neurosurgical literature. ⋯ The findings demonstrate promising potential for application of the ChatGPT in patient education. GPT4 is an accessible tool that can be an immediate solution to enhancing the readability of current neurosurgical literature. Layperson summaries generated by GPT4 would be a valuable addition to a neurosurgical journal and would be likely to improve comprehension for patients using internet resources like PubMed.
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Journal of neurosurgery · Nov 2024
Predictors of trigeminal neuropathy in patients receiving Gamma Knife stereotactic radiosurgery for vestibular schwannoma.
The authors' objective was to validate dosimetric and clinical predictors of the development of trigeminal neuropathy (Tn) in patients treated with stereotactic radiosurgery (SRS) for a diagnosis of vestibular schwannoma (VS). ⋯ The only significant factor in the risk of development of Tn after SRS for VS was the volume of CN V that received ≥ 11 Gy. This should be routinely incorporated into dosimetric planning constraints and patients should be counseled about the risk of adverse effects if it cannot be met. For those with growing VS and a gap to the trigeminal nerve, it may be prudent to provide earlier treatment with SRS to enable application of this dosimetric constraint and reduced risk of Tn.
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Journal of neurosurgery · Nov 2024
The feasibility and clinical outcome of endoscopic transorbital transcavernous approaches with or without petrosectomy for petroclival lesions.
Petroclival tumors such as petroclival meningiomas or trigeminal schwannomas extending to the posterior cranial fossa are challenging to treat due to their deep-seated location and proximity to critical neurovascular structures. This study aimed to evaluate the feasibility, safety, and clinical outcomes of endoscopic transorbital surgery for the resection of central skull base tumors involving the petroclival area. ⋯ Endoscopic transorbital surgery appears to be a safe and effective technique for the resection of petroclival lesions, offering excellent visualization and access to the tumor while minimizing morbidity. However, further studies with larger patient cohorts and longer follow-up are warranted to validate the long-term efficacy and safety of this approach. This study contributes to the growing body of evidence supporting the utility of endoscopic transorbital techniques in skull base surgery.