{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T23:24:34Z","timestamp":1787268274490,"version":"build-2736575974"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>A retrospective chart review was conducted on patients undergoing retrosigmoid craniotomies at a single institution from 2019 onward. Patients with prior craniotomies or less than 1 month of follow-up were excluded.<\/jats:p>\n                  <jats:p>Among 73 patients, 29 (39.7%) underwent the modified Dandy technique. Baseline characteristics were similar between the two groups, with 41 of them being female (56.2%), the median age being 59 (interquartile range [IQR]: 50\u201367), and 44 having never smoked (60.3%). The most common indications for surgery were vestibular schwannomas (53.4%), meningiomas (24.7%), and metastatic lesions (15.1%), while the rest were other lesions (6.8%). In the modified and control groups, the follow-up duration was 8.9 months (IQR: 5\u201310.6) and 15.9 months (IQR: 8\u201323.9; p\u2009=\u20090.01). Wound complications occurred in 3.4% of the modified group (i.e., superficial wound erythema), compared to 15.9% in the control group (p\u2009=\u20090.02). These complications resulted in three reoperations (6.8%; p\u2009=\u20090.32) and seven readmissions (15.9%) in the control group (p\u2009=\u20090.03). Three patients in the control group (6.8%) had multiple complications, one of whom required multiple reoperations for persistent pseudo-meningocele. Notably, all complications except one occurred within 30 days.<\/jats:p>\n                  <jats:p>This study suggests that the modified technique may reduce wound-related complications following retrosigmoid craniotomies, though further research is required to confirm its efficacy.<\/jats:p>","DOI":"10.1055\/a-2706-1385","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T23:01:16Z","timestamp":1759273276000},"page":"610-615","source":"Crossref","is-referenced-by-count":0,"title":["Modified Dandy Stair-Step Incision for Retrosigmoid Craniotomies to Reduce Postoperative Complications in Skull Base Surgery"],"prefix":"10.1055","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4974-3983","authenticated-orcid":false,"given":"Jean","family":"Filo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Alwakaa","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B.","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael A.","family":"Vega","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United 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Surg"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.jocn.2016.03.015","article-title":"Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage","volume":"32","author":"R S Tubbs","year":"2016","journal-title":"J Clin Neurosci"}],"container-title":["Journal of Neurological Surgery Part B: Skull 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