{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:32:32Z","timestamp":1793341952073,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess the safety and efficacy of intrathecal fluorescein administration during transmastoid repair of temporal lobe encephaloceles and identify predictors for intraoperative fluorescein identification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a retrospective case-control study of consecutive adult patients with temporal lobe encephaloceles repaired via transmastoid approach from October 2012 to October 2024 at a single tertiary academic medical center. Medical records of qualifying patients were searched for demographics, diagnostic workup, disease characteristics, and intraoperative and postoperative outcomes. Analysis incorporated the Wilcoxon rank-sum, Pearson\u2019s X\n                      <jats:sup>2<\/jats:sup>\n                      , and Fisher\u2019s exact tests, along with unadjusted Kaplan-Meier estimates. Outcomes included encephalocele recurrence and symptomatic resolution rates, fluorescein complications, and rates and predictors of intraoperative fluorescein identification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      38 patients met inclusion criteria (age 59.8\u2009+\u200911.9\u2009years, BMI 35.8\u2009+\u20098.7\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 23 [60.5%] female). Recurrence (0% vs 11.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.54) and symptom resolution (83.3% vs 88.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.64) rates did not differ between patients who received and did not receive intrathecal fluorescein. No fluorescein-related complications were reported. Fluorescein was intraoperatively detected in six-twelfths cases, yielding a sensitivity of 50%. No demographic or clinical variables, including higher BMI, history of prior encephalocele, and size of largest defect, were associated with intraoperative fluorescein identification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Intrathecal fluorescein administration preliminarily appears to be a safe adjunctive tool to identify the leak source in the transmastoid repair of temporal lobe encephaloceles, but its risk-benefit ratio remains up for debate. Higher-powered studies are necessary to explore its utility in specific circumstances and to determine which patients may benefit most.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894261470543","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:52:15Z","timestamp":1784537535000},"page":"922-928","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of Intrathecal Fluorescein in Transmastoid Repair of Temporal Encephaloceles"],"prefix":"10.1177","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3315-0665","authenticated-orcid":false,"given":"Keshav V.","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Le","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8519-5366","authenticated-orcid":false,"given":"Randall James","family":"Harley","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Hwa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ruckenstein","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas C.","family":"Bigelow","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.31083\/j.jin2203079"},{"key":"e_1_3_2_3_2","volume-title":"Encephalocele","author":"Karsonovich T","year":"2025","unstructured":"Karsonovich T, De Jesus O. 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