{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:24:19Z","timestamp":1794018259436,"version":"4.8.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Incomplete resection of skull base pathology may result in local tumor recurrence. This study investigates the utility of 5-aminolevulinic acid (5-ALA) fluorescence during endoscopic endonasal approaches (EEAs) to increase visibility of pathologic tissue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective multicenter series comprises patients with planned resection of an anterior skull base lesion who received preoperative 5-ALA at two tertiary care centers. Diagnostic use of a blue light endoscope was performed during EEA for all cases. Demographic and tumor characteristics as well as fluorescence status, quality, and homogeneity were assessed for each skull base pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Twenty-eight skull base pathologies underwent blue-light EEA with preoperative 5-ALA, including 15 pituitary adenomas (54%), 4 meningiomas (14%), 3 craniopharyngiomas (11%), 2 Rathke\u2019s cleft cysts (7%), as well as plasmacytoma, esthesioneuroblastoma, and sinonasal squamous cell carcinoma. Of these, 6 (21%) of 28 showed invasive growth into surrounding structures such as dura, bone, or compartments of the cavernous sinus. Tumor fluorescence was detected in 2 cases (7%), with strong fluorescence in 1 tuberculum sellae meningioma and vague fluorescence in 1 pituicytoma. In all other cases fluorescence was absent. Faint fluorescence of the normal pituitary gland was seen in 1 (7%) of 15 cases. A comparison between the particular tumor entities as well as a correlation between invasiveness, WHO grade, Ki-67, and positive fluorescence did not show any significant association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>With the possible exception of meningiomas, 5-ALA fluorescence has limited utility in the majority of endonasal skull base surgeries, although other pathology may be worth investigating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.5.jns201171","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T03:53:01Z","timestamp":1604029981000},"page":"535-541","source":"Crossref","is-referenced-by-count":9,"title":["Limited utility of 5-ALA optical fluorescence in endoscopic endonasal skull base surgery: a multicenter retrospective study"],"prefix":"10.3171","volume":"135","author":[{"given":"Alexander","family":"Micko","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna, Austria;"},{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin I.","family":"Rapoport","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NewYork-Presbyterian Hospital\/Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett E.","family":"Youngerman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NewYork-Presbyterian Hospital\/Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reginald P.","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NewYork-Presbyterian Hospital\/Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Kosty","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NewYork-Presbyterian Hospital\/Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Brunswick","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Shahrestani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California; 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