{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:18:15Z","timestamp":1783084695263,"version":"3.54.6"},"reference-count":45,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Endoscope-assisted posterior fossa decompression with duraplasty (PFDD) is a minimally invasive alternative treatment for Chiari I malformation; however, its comparative effectiveness remains unclear. Therefore, this study aimed to compare the outcomes of conventional open decompression with those of endoscope-assisted minimally invasive decompression combined with duraplasty to assess the balance between limited surgical exposure and associated technical challenges. Materials and Methods: This retrospective single-center study compared 22 patients who underwent endoscope-assisted PFDD with a historical cohort of 16 patients treated with conventional open PFDD. Patients with C1\u20132 instability, prior craniovertebral surgery, or concomitant pathology requiring an alternative surgical strategy were excluded. The clinical outcomes, radiological findings, surgical variables, and complications were analyzed. Results: Clinical improvement, overall recovery, and 3-month Chicago Chiari Outcome Scale (CCOS) scores were comparable between the groups. The endoscopic group had higher CCOS scores at discharge. Syrinx resolution rates were similar, whereas postoperative cisterna magna expansion was more limited in the endoscopic cohort. The endoscopic approach was associated with a significantly shorter incision length and earlier mobilization. The rates of complications, including pseudomeningocele, cerebrospinal fluid fistula, and wound infection, did not differ significantly between the groups. Conclusions: Endoscope-assisted PFDD may be a less invasive alternative with comparable short-term clinical and radiological outcomes. Despite the technical challenges related to a limited working corridor, it can be considered a feasible option for selected patients.<\/jats:p>","DOI":"10.3390\/medicina62071285","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:34:11Z","timestamp":1783071251000},"page":"1285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscope-Assisted Versus Conventional Posterior Fossa Decompression with Duraplasty for Chiari I Malformation: A Single-Center Comparative Study"],"prefix":"10.3390","volume":"62","author":[{"given":"Mahmut","family":"\u00c7amlar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, \u0130zmir City Hospital, Izmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3875-859X","authenticated-orcid":false,"given":"Umut Tan","family":"Sevgi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, \u0130zmir City Hospital, Izmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4371-7015","authenticated-orcid":false,"given":"Mustafa Eren","family":"Y\u00fcnc\u00fc","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, \u0130zmir City Hospital, Izmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4586-5486","authenticated-orcid":false,"given":"Abdullah","family":"Bozoklar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, \u0130zmir City Hospital, Izmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevzat Semih","family":"Parlak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, \u0130zmir City Hospital, Izmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7a\u011flar","family":"T\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, \u0130zmir City Hospital, Izmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meryem Merve","family":"\u00d6ren \u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Public Health, \u0130stanbul Faculty of Medicine, \u0130stanbul University, Istanbul 34093, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Karada\u011f","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, \u0130zmir City Hospital, Izmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1097\/00006123-199905000-00042","article-title":"Chiari I Malformation Redefined: Clinical and Radiographic Findings for 364 Symptomatic Patients","volume":"44","author":"Milhorat","year":"1999","journal-title":"Neurosurgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"640127","DOI":"10.1155\/2012\/640127","article-title":"Surgical Management of Patients with Chiari I Malformation","volume":"2012","author":"Siasios","year":"2012","journal-title":"Int. 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