{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:01:03Z","timestamp":1781190063918,"version":"3.54.1"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Skull base chordomas (SBCs) often present with cranial nerve (CN) VI deficits. Studies have not assessed the prognosis and predictive factors for CN VI recovery among patients presenting with CN VI deficits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The medical records of patients who underwent resection for primary chordoma from 2001 to 2020 were reviewed. Those presenting with CN VI palsy were identified. The extent of CN VI deficit was determined to be partial or complete based on the Scott-Kraft score. The change in deficit from baseline was recorded within 3 days of surgery and at the 6-month follow-up. The postoperative course was followed until partial and\/or complete deficit recovery. Univariate logistic regression models were created to predict improvement or resolution of CN VI deficit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 113 patients with primary SBC were identified, 34 of whom presented with CN VI deficits: 24 (73%) with partial and 9 (27%) with complete deficits. The extent of deficit in 1 patient was unable to be determined. The median duration of deficit preoperatively was 3.6 months, and CN VI was most commonly radiographically abutted at the prepontine cistern and Dorello\u2019s canal. Twenty-three (68%) patients experienced at least partial CN VI recovery (mean 61 days, range 2\u2013174 days). Nineteen (56%) patients experienced complete CN VI recovery (mean 162 days, range 2\u2013469 days). No patients whose CN VI deficit worsened immediately after surgery achieved improvement in CN VI function at 6 months (p = 0.001). Preoperative partial (relative to complete) CN VI deficit was associated with greater odds of CN VI deficit improvement by 6 months (OR 7.7, p = 0.028). Factors not associated with deficit resolution included duration of deficit, CN VI involvement by tumor, total segments abutted by tumor, sex, age at diagnosis, gross-total resection, tumor volume, and adjuvant radiation therapy, although this analysis may have been underpowered to detect small differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Overall, 68% of patients achieved at least partial recovery in CN VI function after endoscopic skull base surgery. Among patients with partial CN VI palsy at baseline, 83% achieved CN VI recovery within 6 months and 75% achieved complete recovery within 14 months. For patients who presented with a complete CN VI deficit, within those same time frames, 33% and 11% achieved partial and complete recovery, respectively. Complete preoperative CN VI deficit was associated with lower odds of CN VI recovery by 6 months. The duration of preoperative deficit does not predict functional CN VI recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.8.jns232831","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T20:29:13Z","timestamp":1737145753000},"page":"1682-1690","source":"Crossref","is-referenced-by-count":0,"title":["Skull base chordomas presenting with abducens nerve deficits: clinical characteristics and predictive factors for deficit improvement or resolution"],"prefix":"10.3171","volume":"142","author":[{"given":"Nallammai","family":"Muthiah","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary C.","family":"Gersey","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Le","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussam","family":"Abou-Al-Shaar","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Tonya","family":"Stefko","sequence":"additional","affiliation":[{"name":"Neuro-ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle R.","family":"Bonhomme","sequence":"additional","affiliation":[{"name":"Neuro-ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Kocasarac","sequence":"additional","affiliation":[{"name":"Neuro-ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl H.","family":"Snyderman","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios A.","family":"Zenonos","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Neurosurg Clin N Am","first-page":"437","article-title":"Chordomas: a review","volume":"26","author":"George B","year":"2015","unstructured":"George B, Bresson D, Herman P, Froelich S. Chordomas: a review. Neurosurg Clin N Am. 2015;26(3):437\u2013452."},{"key":"b2","series-title":"StatPearls","article-title":"Chordoma","author":"Tenny S","year":"2024","unstructured":"Tenny S, Varacallo M. Chordoma. In: StatPearls. StatPearls Publishing; 2024. Accessed October 1, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430846\/"},{"issue":"1","key":"b3","series-title":"J Clin Neurosci","first-page":"7","article-title":"Skull base chordomas: presentation of six cases and review of the literature","volume":"1","author":"Favre J","year":"1994","unstructured":"Favre J, Deruaz JP, Uske A, de Tribolet N. Skull base chordomas: presentation of six cases and review of the literature. J Clin Neurosci. 1994;1(1):7\u201318."},{"issue":"3","key":"b4","series-title":"Laryngoscope","first-page":"513","article-title":"Can ophthalmologic examination predict abducens nerve recovery after endoscopic skull base surgery?","volume":"131","author":"Whelan RL","year":"2021","unstructured":"Whelan RL, McDowell M, Chou C,  Can ophthalmologic examination predict abducens nerve recovery after endoscopic skull base surgery?. Laryngoscope. 2021;131(3):513\u2013517."},{"key":"b5","series-title":"Trans Am Ophthalmol Soc","first-page":"148","article-title":"Ocular manifestations of intracranial chordomas","volume":"78","author":"Bagan SM","year":"1980","unstructured":"Bagan SM, Hollenhorst RW. Ocular manifestations of intracranial chordomas. Trans Am Ophthalmol Soc. 1980;78:148\u2013155."},{"issue":"1","key":"b6","series-title":"Am J Ophthalmol","first-page":"97","article-title":"Neuro-ophthalmologic findings in chordoma and chondrosarcoma of the skull base","volume":"115","author":"Volpe NJ","year":"1993","unstructured":"Volpe NJ, Liebsch NJ, Munzenrider JE, Lessell S. Neuro-ophthalmologic findings in chordoma and chondrosarcoma of the skull base. Am J Ophthalmol. 1993;115(1):97\u2013104."},{"key":"b7","series-title":"StatPearls","article-title":"Neuroanatomy, cranial nerve 6 (abducens)","author":"Nguyen V","year":"2024","unstructured":"Nguyen V, Reddy V, Varacallo M. Neuroanatomy, cranial nerve 6 (abducens). In: StatPearls. StatPearls Publishing; 2024.Accessed October 1, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430711\/"},{"issue":"7","key":"b8","series-title":"Ophthalmology","first-page":"1300","article-title":"Photographic and clinical techniques for outcome assessment in sixth nerve palsy","volume":"108","author":"Holmes JM","year":"2001","unstructured":"Holmes JM, Hohberger GG, Leske DA. Photographic and clinical techniques for outcome assessment in sixth nerve palsy. Ophthalmology. 2001;108(7):1300\u20131307."},{"issue":"5","key":"b9","series-title":"Ophthalmology","first-page":"676","article-title":"Botulinum toxin injection in the management of lateral rectus paresis","volume":"92","author":"Scott AB","year":"1985","unstructured":"Scott AB, Kraft SP. Botulinum toxin injection in the management of lateral rectus paresis. Ophthalmology. 1985;92(5):676\u2013683."},{"issue":"3","key":"b10","series-title":"J Neurosurg","first-page":"864","article-title":"Minimally invasive extraocular cranial nerve electromyography","volume":"139","author":"Adams GM","year":"2023","unstructured":"Adams GM, Crammond DJ, Shandal V,  Minimally invasive extraocular cranial nerve electromyography. J Neurosurg. 2023;139(3):864\u2013872."},{"issue":"1","key":"b11","series-title":"Neurosurgery","first-page":"144","article-title":"Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies","volume":"67","author":"Barges-Coll J","year":"2010","unstructured":"Barges-Coll J, Fernandez-Miranda JC, Prevedello DM,  Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies. Neurosurgery. 2010;67(1):144\u2013154."},{"issue":"2","key":"b12","series-title":"J Neurosurg Pediatr","first-page":"147","article-title":"Intraoperative neurophysiological monitoring during endoscopic endonasal surgery for pediatric skull base tumors","volume":"17","author":"Elangovan C","year":"2016","unstructured":"Elangovan C, Singh SP, Gardner P,  Intraoperative neurophysiological monitoring during endoscopic endonasal surgery for pediatric skull base tumors. J Neurosurg Pediatr. 2016;17(2):147\u2013155."},{"issue":"1 Suppl Operative","key":"b13","series-title":"Neurosurgery","first-page":"ons64","article-title":"Somatosensory evoked potential monitoring during endoscopic endonasal approach to skull base surgery: analysis of observed changes","volume":"69","author":"Thirumala PD","year":"2011","unstructured":"Thirumala PD, Kassasm AB, Habeych M,  Somatosensory evoked potential monitoring during endoscopic endonasal approach to skull base surgery: analysis of observed changes. Neurosurgery. 2011;69(1 Suppl Operative):ons64\u2013ons76."},{"issue":"4","key":"b14","series-title":"J Neurol Surg B Skull Base","first-page":"236","article-title":"Value of free-run electromyographic monitoring of lower cranial nerves in endoscopic endonasal approach to skull base surgeries","volume":"73","author":"Thirumala PD","year":"2012","unstructured":"Thirumala PD, Mohanraj SK, Habeych M,  Value of free-run electromyographic monitoring of lower cranial nerves in endoscopic endonasal approach to skull base surgeries. J Neurol Surg B Skull Base. 2012;73(4):236\u2013244."},{"issue":"7","key":"b15","series-title":"Can J Ophthalmol","first-page":"436","article-title":"Indications and outcomes of strabismus repair in visually mature patients","volume":"32","author":"Gill MK","year":"1997","unstructured":"Gill MK, Drummond GT. Indications and outcomes of strabismus repair in visually mature patients. Can J Ophthalmol. 1997;32(7):436\u2013440."},{"issue":"3","key":"b16","series-title":"J AAPOS","first-page":"142.e1","article-title":"Surgical outcomes following strabismus surgery for abducens nerve palsy","volume":"27","author":"O\u2019Brien JC","year":"2023","unstructured":"O\u2019Brien JC, Melson AT, Bryant JC, Ding K, Farris BK, Siatkowski RM. Surgical outcomes following strabismus surgery for abducens nerve palsy. J AAPOS. 2023;27(3):142.e1\u2013142.e6."},{"issue":"3","key":"b1","series-title":"Neurosurg Clin N Am","first-page":"437","article-title":"Chordomas: a review","volume":"26","author":"George B","year":"2015","unstructured":"George B, Bresson D, Herman P, Froelich S. Chordomas: a review. Neurosurg Clin N Am. 2015;26(3):437\u2013452."},{"key":"b2","series-title":"StatPearls","article-title":"Chordoma","author":"Tenny S","year":"2024","unstructured":"Tenny S, Varacallo M. Chordoma. In: StatPearls. StatPearls Publishing; 2024. Accessed October 1, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430846\/"},{"issue":"1","key":"b3","series-title":"J Clin Neurosci","first-page":"7","article-title":"Skull base chordomas: presentation of six cases and review of the literature","volume":"1","author":"Favre J","year":"1994","unstructured":"Favre J, Deruaz JP, Uske A, de Tribolet N. Skull base chordomas: presentation of six cases and review of the literature. J Clin Neurosci. 1994;1(1):7\u201318."},{"issue":"3","key":"b4","series-title":"Laryngoscope","first-page":"513","article-title":"Can ophthalmologic examination predict abducens nerve recovery after endoscopic skull base surgery?","volume":"131","author":"Whelan RL","year":"2021","unstructured":"Whelan RL, McDowell M, Chou C,  Can ophthalmologic examination predict abducens nerve recovery after endoscopic skull base surgery?. Laryngoscope. 2021;131(3):513\u2013517."},{"key":"b5","series-title":"Trans Am Ophthalmol Soc","first-page":"148","article-title":"Ocular manifestations of intracranial chordomas","volume":"78","author":"Bagan SM","year":"1980","unstructured":"Bagan SM, Hollenhorst RW. Ocular manifestations of intracranial chordomas. Trans Am Ophthalmol Soc. 1980;78:148\u2013155."},{"issue":"1","key":"b6","series-title":"Am J Ophthalmol","first-page":"97","article-title":"Neuro-ophthalmologic findings in chordoma and chondrosarcoma of the skull base","volume":"115","author":"Volpe NJ","year":"1993","unstructured":"Volpe NJ, Liebsch NJ, Munzenrider JE, Lessell S. Neuro-ophthalmologic findings in chordoma and chondrosarcoma of the skull base. Am J Ophthalmol. 1993;115(1):97\u2013104."},{"key":"b7","series-title":"StatPearls","article-title":"Neuroanatomy, cranial nerve 6 (abducens)","author":"Nguyen V","year":"2024","unstructured":"Nguyen V, Reddy V, Varacallo M. Neuroanatomy, cranial nerve 6 (abducens). In: StatPearls. StatPearls Publishing; 2024.Accessed October 1, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430711\/"},{"issue":"7","key":"b8","series-title":"Ophthalmology","first-page":"1300","article-title":"Photographic and clinical techniques for outcome assessment in sixth nerve palsy","volume":"108","author":"Holmes JM","year":"2001","unstructured":"Holmes JM, Hohberger GG, Leske DA. Photographic and clinical techniques for outcome assessment in sixth nerve palsy. Ophthalmology. 2001;108(7):1300\u20131307."},{"issue":"5","key":"b9","series-title":"Ophthalmology","first-page":"676","article-title":"Botulinum toxin injection in the management of lateral rectus paresis","volume":"92","author":"Scott AB","year":"1985","unstructured":"Scott AB, Kraft SP. Botulinum toxin injection in the management of lateral rectus paresis. Ophthalmology. 1985;92(5):676\u2013683."},{"issue":"3","key":"b10","series-title":"J Neurosurg","first-page":"864","article-title":"Minimally invasive extraocular cranial nerve electromyography","volume":"139","author":"Adams GM","year":"2023","unstructured":"Adams GM, Crammond DJ, Shandal V,  Minimally invasive extraocular cranial nerve electromyography. J Neurosurg. 2023;139(3):864\u2013872."},{"issue":"1","key":"b11","series-title":"Neurosurgery","first-page":"144","article-title":"Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies","volume":"67","author":"Barges-Coll J","year":"2010","unstructured":"Barges-Coll J, Fernandez-Miranda JC, Prevedello DM,  Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies. Neurosurgery. 2010;67(1):144\u2013154."},{"issue":"2","key":"b12","series-title":"J Neurosurg Pediatr","first-page":"147","article-title":"Intraoperative neurophysiological monitoring during endoscopic endonasal surgery for pediatric skull base tumors","volume":"17","author":"Elangovan C","year":"2016","unstructured":"Elangovan C, Singh SP, Gardner P,  Intraoperative neurophysiological monitoring during endoscopic endonasal surgery for pediatric skull base tumors. J Neurosurg Pediatr. 2016;17(2):147\u2013155."},{"issue":"1 Suppl Operative","key":"b13","series-title":"Neurosurgery","first-page":"ons64","article-title":"Somatosensory evoked potential monitoring during endoscopic endonasal approach to skull base surgery: analysis of observed changes","volume":"69","author":"Thirumala PD","year":"2011","unstructured":"Thirumala PD, Kassasm AB, Habeych M,  Somatosensory evoked potential monitoring during endoscopic endonasal approach to skull base surgery: analysis of observed changes. Neurosurgery. 2011;69(1 Suppl Operative):ons64\u2013ons76."},{"issue":"4","key":"b14","series-title":"J Neurol Surg B Skull Base","first-page":"236","article-title":"Value of free-run electromyographic monitoring of lower cranial nerves in endoscopic endonasal approach to skull base surgeries","volume":"73","author":"Thirumala PD","year":"2012","unstructured":"Thirumala PD, Mohanraj SK, Habeych M,  Value of free-run electromyographic monitoring of lower cranial nerves in endoscopic endonasal approach to skull base surgeries. J Neurol Surg B Skull Base. 2012;73(4):236\u2013244."},{"issue":"7","key":"b15","series-title":"Can J Ophthalmol","first-page":"436","article-title":"Indications and outcomes of strabismus repair in visually mature patients","volume":"32","author":"Gill MK","year":"1997","unstructured":"Gill MK, Drummond GT. Indications and outcomes of strabismus repair in visually mature patients. Can J Ophthalmol. 1997;32(7):436\u2013440."},{"issue":"3","key":"b16","series-title":"J AAPOS","first-page":"142.e1","article-title":"Surgical outcomes following strabismus surgery for abducens nerve palsy","volume":"27","author":"O\u2019Brien JC","year":"2023","unstructured":"O\u2019Brien JC, Melson AT, Bryant JC, Ding K, Farris BK, Siatkowski RM. Surgical outcomes following strabismus surgery for abducens nerve palsy. 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