{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:44:06Z","timestamp":1789749846499,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Traditional management of olfactory neuroblastoma (ONB) includes margin\u2010negative resection with removal of cribriform plate, dura, and olfactory bulb, regardless of intracranial disease. This approach may be overtreating certain patients. Our investigation examines risk factors associated with occult intracranial disease to optimize therapeutic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, multi\u2010institutional cohort study examined clinical covariates associated with occult intracranial involvement. Patient demographics, staging, Hyam's grade, and pathologic involvement of dura, olfactory bulb\/tract, and brain were collected. Diagnostic imaging was reviewed. Positive and negative predictive value (NPV) were estimated along with effect size estimates. Cox hazard regression examined associations with overall survival (OS) and disease\u2010free survival (DFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 224 subjects with new diagnoses of ONB (2005\u20132021) were identified. Skull base bone involvement on computed tomography (CT) had the highest NPV for pathologic dura (88.0%), olfactory bulb (88%), and brain involvement (97.3%). Hyam's grade category was significantly associated with dural involvement (<jats:italic>\u03c6<jats:sub>C<\/jats:sub><\/jats:italic>\u00a0=\u00a00.26; 95% confidence interval [CI]: 0.16, 0.42). Subjects without radiologic skull base involvement (<jats:italic>n<\/jats:italic>\u00a0=\u00a066) had pathologic positivity of 12.1%. Within this subgroup, Hyam's grade was clinically significant for dural positivity (<jats:italic>\u03c6<\/jats:italic>\u00a0=\u00a00.34; 95% CI: \u22120.12, 0.71) with 28.6% involvement in high grade tumors. Neither clinical nor pathologic positivity of intracranial structures were associated with significantly different OS or DFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both CT and magnetic resonance imaging (MRI) had reasonably good NPV for involvement of dura and olfactory bulb. Higher Hyam's grade was associated with dural involvement. Patients with low\u2010grade tumors not involving the skull base may be suitable for avoiding skull base resection; however, further investigation is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23145","type":"journal-article","created":{"date-parts":[[2023,2,26]],"date-time":"2023-02-26T05:34:07Z","timestamp":1677389647000},"page":"1876-1888","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Radiographic predictors of occult intracranial involvement in olfactory neuroblastoma patients"],"prefix":"10.1002","volume":"13","author":[{"given":"Mathew","family":"Geltzeiler","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3745-2727","authenticated-orcid":false,"given":"Garret 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