{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:02:59Z","timestamp":1793325779489,"version":"4.5.0"},"reference-count":15,"publisher":"Korean Neurosurgical Society","issue":"6","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["jkns.or.kr"],"crossmark-restriction":true},"short-container-title":["J Korean Neurosurg Soc"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:p>Objective : This study aimed to compare the clinical outcomes and risk of two skull base reconstruction methods after expanded expanded endoscopic approach (EEA), viz. postoperative cerebrospinal fluid (CSF) lumbar drainage (L-method) and injectable hydroxyapatite cement without lumbar drainage (H-method).Methods : We enrolled 211 consecutive patients with grade 2 or 3 intraoperative CSF leakage during EEA. The most common preoperative diagnoses were pituitary adenoma (n=62, 29%), meningioma (n=50, 24%), and craniopharyngioma (n=28, 13%). Vascularized nasoseptal flaps were used in most cases (98%). We used the L-method and H-method in 83 (39%) and 103 patients (49%), respectively.Results : The overall reconstruction-related complication and postoperative CSF leakage rates were 8% (18\/211) and 6% (12\/211), respectively. The complications included postoperative CSF leakage (n=12), infection (n=4), postoperative optic nerve compression (n=1), and brain herniation (n=1). The postoperative complication and CSF leakage rates did not differ significantly between the L-method (12% and 10%, respectively) and H-method (8% and 4%, respectively) (&lt;i&gt;p&lt;\/i&gt;=0.326 and 0.112, respectively). Postoperative hospital stay was significantly shorter with the H-method (6.9 days) compared to the L-method (10.0 days) (&lt;i&gt;p&lt;\/i&gt;&lt;0.001). However, the postoperative infection rate of the H-method (n=4) was higher than that of the L-method (n=0; &lt;i&gt;p&lt;\/i&gt;=0.070).Conclusion : Skull base reconstruction using hydroxyapatite effectively prevented postoperative CSF leakage and ensured patient comfort and shorter hospitalization without postoperative lumbar drainage, although postoperative infection requires consideration.<\/jats:p>","DOI":"10.3340\/jkns.2025.0027","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:41:00Z","timestamp":1745466060000},"page":"761-770","update-policy":"https:\/\/doi.org\/10.3340\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of the Lumbar Drain and the Hydroxyapatite Methods for Cerebrospinal Fluid Leakage after Endoscopic Skull Base Surgery"],"prefix":"10.3340","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7311-2172","authenticated-orcid":true,"given":"Minho","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5313-5027","authenticated-orcid":true,"given":"Gung Ju","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3271-4784","authenticated-orcid":true,"given":"Juhee","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2970-8259","authenticated-orcid":true,"given":"Yukyeng","family":"Byeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4089-987X","authenticated-orcid":true,"given":"Chaejin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9215-6867","authenticated-orcid":true,"given":"Ji Heui","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5523-3798","authenticated-orcid":true,"given":"Sang Woo","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2761-0373","authenticated-orcid":true,"given":"Chang-Ki","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7385-2368","authenticated-orcid":true,"given":"Jeong Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9009-4191","authenticated-orcid":true,"given":"Yong Hwy","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7519-3594","authenticated-orcid":true,"given":"Doo-Sik","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8852-6503","authenticated-orcid":true,"given":"Young-Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1892","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-012-1293-5"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000255354.64077.66"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000234933.37779.e4"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-42097-y"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2014.28.4109"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2014.06.004"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000297074.13423.f5"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.02.178"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3171\/2016.12.jns161920"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2020.0231"},{"key":"ref11","first-page":"E53","volume-title":"Icing and multilayering technique of injectable hydroxyapatite cement paste for cranial base reconstruction after transsphenoidal surgery: technical note","author":"Kitano","year":"2007"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3171\/2017.11.jns171337"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.906162"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3171\/2019.3.jns19492"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3171\/2018.4.jns172447"}],"container-title":["Journal of Korean Neurosurgical Society"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/jkns.or.kr\/upload\/pdf\/jkns-2025-0027.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkns.or.kr\/journal\/view.php?doi=10.3340\/jkns.2025.0027","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkns.or.kr\/upload\/pdf\/jkns-2025-0027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T01:53:49Z","timestamp":1761789229000},"score":1,"resource":{"primary":{"URL":"http:\/\/jkns.or.kr\/journal\/view.php?doi=10.3340\/jkns.2025.0027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,11]]}},"URL":"https:\/\/doi.org\/10.3340\/jkns.2025.0027","relation":{},"ISSN":["2005-3711","1598-7876"],"issn-type":[{"value":"2005-3711","type":"print"},{"value":"1598-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,1]]},"assertion":[{"value":"2025-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-24","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}