{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:57:14Z","timestamp":1782997034518,"version":"3.54.5"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["World j. otorhinolaryngol.-head neck surg."],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Endoscopic repair of large anterior skull base (ASB) defects has\u00a0excellent results when using multilayered repairs with a nasoseptal flap. However, in extensive intranasal tumors, a nasoseptal flap may not always be available. One alternative option is a flexible single\u2010layer ASB repair. Initial studies indicate low cerebrospinal fluid leak rates with a single\u2010layer repair. However, the level of frontal lobe support, particularly the propensity for a significant inferior displacement of the frontal lobe, is not known. The goal of this study is to determine the frontal lobe position after single\u2010layer acellular dermal allograft repair in large ASB defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>This cohort study compares the frontal lobe position in adults who underwent endoscopic endonasal ASB tumor resection and single\u2010layer cadaveric dermal matrix repair (ASB cohort) with control subjects without intracranial abnormalities (control cohort). The ASB cohort includes subjects with an ASB defect of \u22655\u2009cm anterior\/posterior and \u22651.5\u2009cm wide and who had imaging at least 2 months after surgery. The frontal lobe position is measured on sagittal CT\/MRI using a reference line from the base of the sella to the nasion. A value of zero indicates that the inferior\u2010most aspect of the frontal lobe is at the level of the nasion\u2212sellar line. A positive value indicates that the frontal lobe is inferior to the nasion\u2212sellar line. The ASB cohort frontal lobe position is compared with the control cohort using the Mann\u2212Whitney <jats:italic>U<\/jats:italic> test. A priori we set an absolute difference of 5\u2009mm as a clinically significant difference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ASB cohort includes 47 subjects who are 57% male with an average age of 60 years (range: 31\u221289 years). The most common ASB pathology is esthesioneuroblastoma (<jats:italic>n<\/jats:italic>\u2009=\u200921) and 81% of the ASB cohort had postoperative radiation. The control cohort includes 20 subjects who are 60% male, with a mean age of 45 years\u00a0(range: 19\u221274 years). The majority of controls underwent imaging for head trauma (<jats:italic>n<\/jats:italic>\u2009=\u200913). The ASB mean frontal lobe position is \u22120.2\u2009mm\u00a0superior to the nasion\u2212sellar line (range: \u22129.2 to 10.4\u2009mm), while the control's mean frontal lobe position is 1.1\u2009mm inferior to the nasion\u2212sellar line. This difference is not statistically significant (<jats:italic>P<\/jats:italic>\u2009=\u20090.13) and does not reach our a priori definition of clinical significance. The frontal lobe position of ASB subjects who had radiation is closer to the nasion\u2212sellar line as compared with those who did not undergo radiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Single\u2010layer acellular dermal graft repair maintains frontal lobe support and position in large ASB defects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjo2.23","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T09:06:06Z","timestamp":1652173566000},"page":"36-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Frontal lobe position after single\u2010layer cadaveric dermal matrix repair of large anterior skull base defects"],"prefix":"10.1002","volume":"8","author":[{"given":"Corinna G.","family":"Levine","sequence":"first","affiliation":[{"name":"Rhinology &amp; Skull Base Surgery, Department of Otolaryngology University of Miami Miller School of Medicine Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah N.","family":"Al\u2010Rasheedi","sequence":"additional","affiliation":[{"name":"Otolaryngology Head &amp; Neck Surgery Jouf University\u2014Medical College Skaka Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Mantero","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Biostatistics Collaboration and Consulting Core Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Al\u2010Bar","sequence":"additional","affiliation":[{"name":"Otolaryngology, King Fahad Hospital of the University Imam Abdulrahman Bin Faisal University Khobar Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy R.","family":"Casiano","sequence":"additional","affiliation":[{"name":"Rhinology &amp; Skull Base Surgery, Department of Otolaryngology University of Miami Miller School of Medicine Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000223"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22475"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814520685"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2014.02.009"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23539"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1325636"},{"key":"e_1_2_11_8_1","volume-title":"Endoscopic Sinonasal Dissection Guide: Including Orbit and Skull Base","author":"Casiano RR","year":"2017"},{"issue":"2","key":"e_1_2_11_9_1","first-page":"139","article-title":"Single layer repair of large anterior skull base defects without vascularized mucosal flap","volume":"78","author":"Yoo F","year":"2017","journal-title":"J Neurol Surg B Skull Base"},{"issue":"5","key":"e_1_2_11_10_1","first-page":"482","article-title":"Comparison of a purely endoscopic three\u2010layer technique versus pericranial flap for reconstruction of anterior skull base defects after sino\u2010nasal tumor resection: assessment of postoperative frontal lobe sagging and frontal lobe falling","volume":"58","author":"Germani RM","year":"2020","journal-title":"Rhinology"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3080"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200303000-00019"}],"container-title":["World Journal of Otorhinolaryngology - Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjo2.23","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjo2.23","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjo2.23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T18:18:41Z","timestamp":1693333121000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjo2.23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/wjo2.23"],"URL":"https:\/\/doi.org\/10.1002\/wjo2.23","archive":["Portico"],"relation":{},"ISSN":["2095-8811","2589-1081"],"issn-type":[{"value":"2095-8811","type":"print"},{"value":"2589-1081","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3]]},"assertion":[{"value":"2021-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}