{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:59:37Z","timestamp":1785452377655,"version":"3.56.0"},"reference-count":8,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Perioperative disruption of circadian rhythm has been implicated in adverse surgical outcomes, but its relationship to recovery and complications in patients undergoing skull base surgery remains uncertain. This prospective cohort study investigates the extent of perioperative circadian disruption, its physiological markers, and its associations with recovery trajectories and postoperative complications.<\/jats:p>\n                  <jats:p>Eighty-two adult patients scheduled for elective skull base tumor resection were enrolled. Serial measurements of serum melatonin and cortisol were obtained preoperatively and on postoperative days 1, 3, and 7. Sleep quality (Pittsburgh Sleep Quality Index), pain scores, and postoperative complications were recorded. Patients were categorized by the degree of combined melatonin and cortisol rhythm disruption. Statistical comparisons between high and low disruption groups were performed for clinical outcomes, complications, and recovery.<\/jats:p>\n                  <jats:p>Significant perioperative suppression of melatonin and elevation of cortisol were observed postoperatively, with a gradual trend toward baseline by day 7. Mean (SD) melatonin fell from 42.4 (18.0) pg\/mL preoperatively to 19.2 (9.9) pg\/mL on day 1 (p\u2009&lt;\u20090.001), while cortisol rose from 14.5 (3.0) to 25.4 (5.7) \u03bcg\/dL (p\u2009&lt;\u20090.001). Sleep scores worsened (mean rising from 6.2 to 14.9, p\u2009&lt;\u20090.001), and the length of stay averaged 7.9\u2009\u00b1\u20093.0 days. Overall, 48.8% had postoperative complications, with CSF leak (23.2%), infection (14.6%), and neurological deficits (11.0%). Patients in the highest circadian disruption group had significantly higher overall complications (73.9% vs. 39.0%, p\u2009=\u20090.042), longer hospital stay (8.0 vs. 7.9 days, p\u2009=\u20090.018), and poorer sleep recovery.<\/jats:p>\n                  <jats:p>Perioperative circadian disruption, quantified by hormonal and sleep indices, is frequent and strongly associated with adverse outcomes following skull base surgery. Strategies to preserve circadian alignment perioperatively could improve recovery and reduce complications.<\/jats:p>","DOI":"10.1055\/s-0046-1819645","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:37:59Z","timestamp":1785451079000},"page":"567-577","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Perioperative Circadian Rhythm Disruption on Recovery and Complications in Skull Base Surgery: A Prospective Cohort Study"],"prefix":"10.1055","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3272-536X","authenticated-orcid":false,"given":"Kanav","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, Vijaypur, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivanya","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Oncoanesthesia and Palliative Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavya","family":"Gupta","sequence":"additional","affiliation":[{"name":"Public Health and Epidemiology, Sher-e-Kashmir University of Agricultural Sciences & Technology, Jammu, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"issue":"07","key":"ref1","first-page":"1006","article-title":"Circadian biomarkers in humans: methodological insights and clinical implications","volume":"15","author":"C Skubic","year":"2025","journal-title":"Cureus"},{"issue":"02","key":"ref2","first-page":"127","article-title":"Complications of skull base surgery: an analysis of 30 cases","volume":"19","author":"T Sakashita","year":"2008","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1055\/s-0036-1583948","article-title":"Complications of open approaches to the skull base","volume":"78","author":"J D Miller","year":"2016","journal-title":"J Neurol Surg"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1007\/s00268-006-0256-5","article-title":"Disturbances in melatonin, cortisol and core body temperature rhythms after major surgery","volume":"31","author":"I G\u00f6genur","year":"2007","journal-title":"World J Surg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1390216","DOI":"10.3389\/fnins.2024.1390216","article-title":"Postoperative cognitive dysfunction: spotlight on light, circadian rhythms, and sleep","volume":"18","author":"E Campbell","year":"2024","journal-title":"Front Neurosci"},{"issue":"01","key":"ref6","first-page":"118","article-title":"Melatonin and cortisol exhibit different circadian rhythm profiles after surgery and during recovery","volume":"8","author":"E Sertaridou","year":"2018","journal-title":"Crit Care"},{"issue":"S 01","key":"ref7","first-page":"A493","article-title":"Relationship between sleep and postoperative delirium: sleep disturbance as a risk factor","volume":"48","author":"M LD Araujo","year":"2025","journal-title":"Sleep (Basel)"},{"issue":"S 04","key":"ref8","first-page":"271","article-title":"Postoperative sleep disorders and their potential impacts on surgical outcomes","volume":"34","author":"S Rampes","year":"2020","journal-title":"Ann Med Surg (Lond)"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0046-1819645.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:39:25Z","timestamp":1785451165000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0046-1819645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":8,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,7,30]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0046-1819645","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]}}}