{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T19:16:00Z","timestamp":1788030960887,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe a multidisciplinary protocol for the resection and reconstruction of complex lateral skull base pathology, based on over two decades of experience in a high\u2010volume tertiary referral center in the United Kingdom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective descriptive analysis of institutional practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A high\u2010volume tertiary skull base unit in the United Kingdom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study presents a summary of clinical experience in managing lateral skull base pathologies\u2014both benign and malignant\u2014over a 20\u2010year period. It outlines a multidisciplinary approach involving ENT, neurosurgery, plastic surgery, anesthesia, radiology, oncology, and specialist nursing teams. The institutional protocol for resection and reconstruction is described, including surgical planning, intraoperative decision\u2010making, perioperative care, and long\u2010term rehabilitation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The integrated multidisciplinary protocol enabled safe and effective management of a broad range of lateral skull base lesions. The team achieved high rates of complete resection and functional reconstruction, with acceptable levels of morbidity. Complex anatomy, tumor extent, and reconstructive requirements were successfully navigated through coordinated team\u2010based planning. The approach has been refined through iterative experience and now serves as a reference pathway for similarly structured centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Effective management of lateral skull base pathology requires a highly coordinated multidisciplinary strategy. The described protocol, developed and implemented over two decades, offers a structured and reproducible approach that may serve as a valuable reference for other high\u2010volume centers involved in skull base surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70321","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T13:06:31Z","timestamp":1782219991000},"page":"587-593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Protocol for Reconstructing Complex Lateral Skull Base Defects: Two Decades of Tertiary Care Experience"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7868-2984","authenticated-orcid":false,"given":"Muhammad Umar","family":"Farooq","sequence":"first","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery\u2013Otology &amp; Skull Base Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2366-2915","authenticated-orcid":false,"given":"Yuri","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery\u2013Otology &amp; Skull Base Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3065-0269","authenticated-orcid":false,"given":"Jameel","family":"Muzaffar","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery\u2013Otology &amp; Skull Base Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Department of Applied Health Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6964-1066","authenticated-orcid":false,"given":"Raghu","family":"Kumar","sequence":"additional","affiliation":[{"name":"Madras ENT Research Foundation Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-7791","authenticated-orcid":false,"given":"Charlie","family":"Huins","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery\u2013Otology &amp; Skull Base Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7343-7105","authenticated-orcid":false,"given":"Peter","family":"Monksfield","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery\u2013Otology &amp; Skull Base Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Baden","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetrius","family":"Evriviades","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0013-719X","authenticated-orcid":false,"given":"Richard","family":"Irving","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery\u2013Otology &amp; Skull Base Surgery University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"2719","volume-title":"Cummings Otolaryngology \u2013 Head and Neck Surgery","author":"Marsh M","year":"2015"},{"key":"e_1_2_8_3_1","volume-title":"CURRENT Diagnosis & Treatment in Otolaryngology \u2013 Head & Neck Surgery","author":"Jackler RK","year":"2012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816634296"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20744"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814520685"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814564536"},{"key":"e_1_2_8_8_1","unstructured":"Medical Research Council Health Research Authority Decision Tool [Internet]. 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