- Strenuous Activity and Intracranial Aneurysm Rupture: Mechanisms, Epidemiology, and Clinical Implications. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):532-537.JN
- CONCLUSIONS: Current evidence supports an association between strenuous physical activity and aneurysm rupture, though absolute risk is low. Individualized activity recommendations should balance rupture risk against cardiovascular benefits of exercise. Further research is needed to develop evidence-based guidelines and refine risk stratification models for patients with unruptured intracranial aneurysms.
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- A Novel BERT-Based Machine Learning Approach for Enhanced CSF Leak Prediction in Endoscopic Endonasal Skull Base Surgery. [Journal Article]
- CONCLUSIONS: BERT NLP model outperforms traditional logistic regression in predicting cerebrospinal fluid leaks after endoscopic skull base surgery, demonstrating superior accuracy with qualitative clinical data, enhancing risk stratification and decision-making.
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- Factors Associated with 30-Day Readmission after Endoscopic Transsphenoidal Surgery: The Critical Role of Dedicated Endocrinology Discharge Coordination. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):572-576.JN
- CONCLUSIONS: Patients with pituitary microadenomas, transient DI, and preoperative cranial nerve palsies were at an increased risk for unplanned 30-day readmission after ETS. Dedicated neuroendocrinology involvement is necessary in the postoperative period to reduce readmission risk in these patients. Identification and careful monitoring of these at-risk populations is necessary, as targeted postdischarge care may prevent readmission and improve both patient and hospital outcomes.
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- Does Debridement of Intracranial Disease in Acute Invasive Fungal Sinusitis Improve Survival? [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):514-522.JN
- CONCLUSIONS: This study is the largest series to examine neurosurgical management of rhinocerebral IFS, demonstrating possible survival benefit with IC debridement in select patients and with highly specialized surgical expertise.
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- Belzutifan in Von Hippel-Lindau-associated Hemangioblastomas: A Systematic Review and Meta-analysis. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):e124-e131.JN
- CONCLUSIONS: Belzutifan demonstrates promising efficacy in VHL-associated HBs, achieving therapeutic responses and reducing tumor progression with minimal need for treatment interruption. Anemia is the most frequent AE but rarely progresses to grade 3; monitoring for transfusions and dose adjustment is recommended. Caution is warranted in interpreting pooled results given the high inter-study heterogeneity (I [2] > 60%), particularly for ORR, rate of dosage decrease, treatment interruption, and anemia. Future studies with larger cohorts are needed to improve reliability and generalizability.
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- Safety and Efficacy of Endoscopic and Microscopic Techniques for Facial Nerve Decompression After Trauma: A Systematic Review and Meta-Analysis. [Journal Article]
- CONCLUSIONS: Both techniques are safe and effective; better efficacy was analyzed with the endoscopic. Further studies with standardized populations are needed.
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- Modified Dandy Stair-Step Incision for Retrosigmoid Craniotomies to Reduce Postoperative Complications in Skull Base Surgery. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):610-615.JN
- Retrosigmoid craniotomies are prone to postoperative complications, including wound complications, necessitating careful surgical closure. A modified Dandy stair-step technique was developed to address these concerns by ensuring a watertight seal, preserving the blood supply, sparing the muscles, and approximating the wound layers precisely under a cranial flap.
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- The Price of Paralysis: Analyzing the Direct Cost of Facial Rehabilitation after Vestibular Schwannoma Resection. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):561-565.JN
- CONCLUSIONS: The median cost associated with facial rehabilitation is relatively low at $3,125; however, this amount varies based on the type of procedures pursued and individual need. Ultimately, a dedicated team of specialists is required to appropriately manage postoperative facial dysfunction in a cost-effective manner.
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- Proton Versus Photon Radiation Therapy for Nasopharyngeal Carcinoma. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):495-501.JN
- CONCLUSIONS: NPC patients demonstrated higher OS following PRT compared with XRT. Prospective trials consisting of larger and more heterogeneous patient populations are warranted to better delineate the therapeutic efficacy of PRT and direct its appropriate use as a primary radiation modality for NPC patients.
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- A Stitch in Time Saves Nine: Retrosigmoid Craniotomy with Layered Suboccipital Muscle Dissection to Prevent Cerebrospinal Fluid Leak and Infection. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):596-603.JN
- CONCLUSIONS: Understanding and respecting anatomical muscle layers during suboccipital dissection significantly reduce wound-related complications and postoperative morbidity. This sharp dissection technique with minimal coagulation is safe, reproducible, and practical, offering functional and cosmetic benefits.
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- Surgical Management of Trigeminal Neuralgia Emerging in the Long-Term after Cerebellopontine Angle Tumor Surgery without Tumor Regrowth. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):604-609.JN
- CONCLUSIONS: Although rare and technically challenging, surgical intervention can be an effective and safe treatment for surgery-associated trigeminal neuralgia. Comprehensive management of all possible etiologies, including separation of the surrounding structures (arteries, veins, cranial nerves, arachnoid, and residual tumor) from the trigeminal nerve, should be considered for complete and secure pain relief under detailed neuromonitoring.
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- Single-Barrel versus Double-Barrel Superficial Temporal Artery-to-Middle Cerebral Artery Bypass in Moyamoya Disease: A Systematic Review and Meta-Analysis of Postoperative Stroke Outcomes. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):538-545.JN
- CONCLUSIONS: Double-barrel STA-MCA bypass does not appear to provide additional postoperative stroke protection or vulnerability compared with the single-barrel; however, given the relatively limited follow-up times, these results may underrepresent long-term benefits. Well-controlled long-term studies are needed to better interrogate the optimal treatment strategies for this vulnerable patient population.
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- Endoscopic Paramaxillary Approach: A Novel Approach to the Middle Cranial Fossa, Hypoglossal Canal, and Jugular Foramen. [Journal Article]
- CONCLUSIONS: The endoscopic paramaxillary approach provides adequate access to the extradural hypoglossal canal, jugular foramen, and middle cranial fossa with preservation of critical neurovascular structures that is more direct and shorter compared with the endoscopic transpterygoid approach.
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- Sinonasal and Skull Base Morbidity from a Modified Nasoseptal Flap versus No Flap in Pituitary Surgery. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):577-583.JN
- CONCLUSIONS: Utilizing a modified NSF in endoscopic transsphenoidal pituitary surgery allows for a sellar reconstruction option without detrimental impact on sinonasal function.
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- Endoscopic Transorbital Approach to Middle Cranial Fossa and Kawase's Triangle-Feasibility, Descriptive and Quantitative Anatomical Study. [Journal Article]J Neurol Surg B Skull Base. 2026 Oct; 87(5):e132-e144.JN
- CONCLUSIONS: The study confirmed the feasibility of using a transorbital endoscope to explore the middle cranial fossa base through a lateral retrocanthal incision, offering improved visualization. However, caution is necessary due to the proximity of intra-orbital structures.
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