{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:26:14Z","timestamp":1794324374936,"version":"4.9.0"},"reference-count":55,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Epidermoid cysts (ECs) commonly extend to involve the ventral cisterns of the cranial base. When present, symptoms arise due to progressive mass effect on the brainstem and adjacent cranial nerves. Historically, a variety of open microsurgical approaches have been used for resection of ECs in this intricate region. In recent years, the endoscopic endonasal approach (EEA) has been proposed as an alternative corridor that avoids crossing the plane of the cranial nerves. To date, there is a paucity of data in the literature regarding the safety and efficacy of the EEA in the treatment of ECs of the ventral cranial base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors reviewed a prospectively acquired database of EEAs for resection of ECs over 8 years at Weill Cornell, NewYork-Presbyterian Hospital. All procedures were performed by the senior authors. Standardized clinical and radiological parameters were assessed before and after surgery. Statistical tests were used to determine the impact of previous surgery and tumor volume on extent of resection and recurrence as well as the method of closure on rate of CSF leak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Between January 2009 and February 2017, 7 patients (4 males and 3 females; age range 16\u201370 years) underwent a total of 8 surgeries for EC resection utilizing the EEA. Transplanum and transclival extensions were performed in 3 and 5 patients, respectively. Methods of closure incorporated a gasket seal in 6 of 8 procedures and a nasoseptal flap in 7 of 8 procedures. Gross-total resection (GTR) was achieved in 43% of patients, and near-total resection (&gt; 95%) was obtained in another 43%. Complications included diabetes insipidus (n = 2), postoperative CSF leak (n = 2), transient third cranial nerve palsy (n = 1), and epistaxis (n = 1). With a mean follow-up of 43.5 months, recurrence has been observed in 2 of 7 patients. In 1 case, reoperation for recurrence was required 71 months following the initial surgery. Use of the gasket-seal technique with nasoseptal flap coverage significantly correlated with the absence of postoperative CSF leakage (p = 0.018). GTR was achieved in 25% of the patients who had prior surgeries and in 50% of patients without previous resections. The mean volume of cysts in which GTR was achieved (4.3 \u00b1 1.8 cm\n                      <jats:sup>3<\/jats:sup>\n                      ) was smaller than that in which subtotal or near-total resection was achieved (12.2 \u00b1 11 cm\n                      <jats:sup>3<\/jats:sup>\n                      , p = 0.134).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The EEA for resection of ECs of the ventral cranial base is a safe and effective operative strategy that avoids crossing the plane of the cranial nerves. In the authors\u2019 experience, gasket-seal closure with nasoseptal flap coverage has been associated with a decreased risk of postoperative CSF leakage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2017.12.jns172575","type":"journal-article","created":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T09:59:19Z","timestamp":1528451959000},"page":"1599-1608","source":"Crossref","is-referenced-by-count":11,"title":["Endoscopic endonasal resection of epidermoid cysts involving the ventral cranial base"],"prefix":"10.3171","volume":"130","author":[{"given":"Jonathan A.","family":"Forbes","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matei","family":"Banu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia Medical College, NewYork-Presbyterian Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Lehner","sequence":"additional","affiliation":[{"name":"Hofstra-Northwell Health School of Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte","family":"Ottenhausen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"La Corte","sequence":"additional","affiliation":[{"name":"University of Milan and Department of Neurosurgery, Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F.","family":"Alalade","sequence":"additional","affiliation":[{"name":"Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar G.","family":"Ord\u00f3\u00f1ez-Rubiano","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York;"},{"name":"Department of Neurological Surgery, Fundaci\u00f3n Universitaria de Ciencias de la Salud (FUCS), Hospital de San Jos\u00e9, Bogot\u00e1, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York;"},{"name":"Department of Otolaryngology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York; and"},{"name":"Department of Neuroscience, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"743","DOI":"10.3171\/2014.11.JNS1481","article-title":"Giant intracranial epidermoids: is total removal feasible?","volume":"122","author":"Aboud E","year":"2015","unstructured":"Aboud E, Abolfotoh M, Pravdenkova S, Gokoglu A, Gokden M, Al-Mefty O: Giant intracranial epidermoids: is total removal feasible? 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