Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery
The landscape of cranial base surgery has undergone monumental transformations over the past several decades. This article serves as a comprehensive survey, detailing both the historical and current techniques and technologies that have propelled this field into an era of unprecedented capabilities...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
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| Series: | Brain Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3425/13/10/1495 |
| _version_ | 1797574423111270400 |
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| author | Corneliu Toader Lucian Eva Catalina-Ioana Tataru Razvan-Adrian Covache-Busuioc Bogdan-Gabriel Bratu David-Ioan Dumitrascu Horia Petre Costin Luca-Andrei Glavan Alexandru Vlad Ciurea |
| author_facet | Corneliu Toader Lucian Eva Catalina-Ioana Tataru Razvan-Adrian Covache-Busuioc Bogdan-Gabriel Bratu David-Ioan Dumitrascu Horia Petre Costin Luca-Andrei Glavan Alexandru Vlad Ciurea |
| author_sort | Corneliu Toader |
| collection | DOAJ |
| description | The landscape of cranial base surgery has undergone monumental transformations over the past several decades. This article serves as a comprehensive survey, detailing both the historical and current techniques and technologies that have propelled this field into an era of unprecedented capabilities and sophistication. In the prologue, we traverse the historical evolution from rudimentary interventions to the state-of-the-art neurosurgical methodologies that define today’s practice. Subsequent sections delve into the anatomical complexities of the anterior, middle, and posterior cranial fossa, shedding light on the intricacies that dictate surgical approaches. In a section dedicated to advanced techniques and modalities, we explore cutting-edge evolutions in minimally invasive procedures, pituitary surgery, and cranial base reconstruction. Here, we highlight the seamless integration of endocrinology, biomaterial science, and engineering into neurosurgical craftsmanship. The article emphasizes the paradigm shift towards “Functionally” Guided Surgery facilitated by intraoperative neuromonitoring. We explore its historical origins, current technologies, and its invaluable role in tailoring surgical interventions across diverse pathologies. Additionally, the digital era’s contributions to cranial base surgery are examined. This includes breakthroughs in endoscopic technology, robotics, augmented reality, and the potential of machine learning and AI-assisted diagnostic and surgical planning. The discussion extends to radiosurgery and radiotherapy, focusing on the harmonization of precision and efficacy through advanced modalities such as Gamma Knife and CyberKnife. The article also evaluates newer protocols that optimize tumor control while preserving neural structures. In acknowledging the holistic nature of cranial base surgery, we advocate for an interdisciplinary approach. The ecosystem of this surgical field is presented as an amalgamation of various medical disciplines, including neurology, radiology, oncology, and rehabilitation, and is further enriched by insights from patient narratives and quality-of-life metrics. The epilogue contemplates future challenges and opportunities, pinpointing potential breakthroughs in stem cell research, regenerative medicine, and genomic tailoring. Ultimately, the article reaffirms the ethos of continuous learning, global collaboration, and patient-first principles, projecting an optimistic trajectory for the field of cranial base surgery in the coming decade. |
| first_indexed | 2024-03-10T21:23:23Z |
| format | Article |
| id | doaj.art-44ff2407c67b49df91a7aa4ddc7a9df9 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T21:23:23Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-44ff2407c67b49df91a7aa4ddc7a9df92023-11-19T15:53:46ZengMDPI AGBrain Sciences2076-34252023-10-011310149510.3390/brainsci13101495Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of NeurosurgeryCorneliu Toader0Lucian Eva1Catalina-Ioana Tataru2Razvan-Adrian Covache-Busuioc3Bogdan-Gabriel Bratu4David-Ioan Dumitrascu5Horia Petre Costin6Luca-Andrei Glavan7Alexandru Vlad Ciurea8Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Neurosurgery, Dunarea de Jos University, 800010 Galati, RomaniaDepartment of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaThe landscape of cranial base surgery has undergone monumental transformations over the past several decades. This article serves as a comprehensive survey, detailing both the historical and current techniques and technologies that have propelled this field into an era of unprecedented capabilities and sophistication. In the prologue, we traverse the historical evolution from rudimentary interventions to the state-of-the-art neurosurgical methodologies that define today’s practice. Subsequent sections delve into the anatomical complexities of the anterior, middle, and posterior cranial fossa, shedding light on the intricacies that dictate surgical approaches. In a section dedicated to advanced techniques and modalities, we explore cutting-edge evolutions in minimally invasive procedures, pituitary surgery, and cranial base reconstruction. Here, we highlight the seamless integration of endocrinology, biomaterial science, and engineering into neurosurgical craftsmanship. The article emphasizes the paradigm shift towards “Functionally” Guided Surgery facilitated by intraoperative neuromonitoring. We explore its historical origins, current technologies, and its invaluable role in tailoring surgical interventions across diverse pathologies. Additionally, the digital era’s contributions to cranial base surgery are examined. This includes breakthroughs in endoscopic technology, robotics, augmented reality, and the potential of machine learning and AI-assisted diagnostic and surgical planning. The discussion extends to radiosurgery and radiotherapy, focusing on the harmonization of precision and efficacy through advanced modalities such as Gamma Knife and CyberKnife. The article also evaluates newer protocols that optimize tumor control while preserving neural structures. In acknowledging the holistic nature of cranial base surgery, we advocate for an interdisciplinary approach. The ecosystem of this surgical field is presented as an amalgamation of various medical disciplines, including neurology, radiology, oncology, and rehabilitation, and is further enriched by insights from patient narratives and quality-of-life metrics. The epilogue contemplates future challenges and opportunities, pinpointing potential breakthroughs in stem cell research, regenerative medicine, and genomic tailoring. Ultimately, the article reaffirms the ethos of continuous learning, global collaboration, and patient-first principles, projecting an optimistic trajectory for the field of cranial base surgery in the coming decade.https://www.mdpi.com/2076-3425/13/10/1495cranial base surgeryminimally invasive techniquesintraoperative neuromonitoringadvanced imagingrobotics in neurosurgeryradiosurgery |
| spellingShingle | Corneliu Toader Lucian Eva Catalina-Ioana Tataru Razvan-Adrian Covache-Busuioc Bogdan-Gabriel Bratu David-Ioan Dumitrascu Horia Petre Costin Luca-Andrei Glavan Alexandru Vlad Ciurea Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery Brain Sciences cranial base surgery minimally invasive techniques intraoperative neuromonitoring advanced imaging robotics in neurosurgery radiosurgery |
| title | Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery |
| title_full | Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery |
| title_fullStr | Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery |
| title_full_unstemmed | Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery |
| title_short | Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery |
| title_sort | frontiers of cranial base surgery integrating technique technology and teamwork for the future of neurosurgery |
| topic | cranial base surgery minimally invasive techniques intraoperative neuromonitoring advanced imaging robotics in neurosurgery radiosurgery |
| url | https://www.mdpi.com/2076-3425/13/10/1495 |
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