Understanding frozen section histopathology in Sinonasal and anterior skull base malignancy and proposed reporting guidelines

Mclean, Tim; Fitzgerald, Conall; Eagan, Alana; Long, Sallie M.; Cracchiolo, Jennifer; Shah, Jatin; Patel, Snehal; Ganly, Ian; Dogan, Snjezana; Cohen, Marc A.; ,

doi:10.1002/jso.27429

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…This region can exhibit benign tumors, such as meningiomas, and malignancies, such as squamous cell carcinomas and esthesioneuroblastomas ( 48 ). These disorders frequently exploit the skull base's inherent pathways and delicate barriers, resulting in potential difficulties such as cerebrospinal fluid leaks and the spread of the ailment within the skull ( 49 , 50 ).…”

Section: Anterior Skull Base Surgerymentioning

confidence: 99%

Narrative review of patient-specific 3D visualization and reality technologies in skull base neurosurgery: enhancements in surgical training, planning, and navigation

Isikay,

Cekic,

Baylarov

et al. 2024

Front. Surg.

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Recent advances in medical imaging, computer vision, 3-dimensional (3D) modeling, and artificial intelligence (AI) integrated technologies paved the way for generating patient-specific, realistic 3D visualization of pathological anatomy in neurosurgical conditions. Immersive surgical simulations through augmented reality (AR), virtual reality (VR), mixed reality (MxR), extended reality (XR), and 3D printing applications further increased their utilization in current surgical practice and training. This narrative review investigates state-of-the-art studies, the limitations of these technologies, and future directions for them in the field of skull base surgery. We begin with a methodology summary to create accurate 3D models customized for each patient by combining several imaging modalities. Then, we explore how these models are employed in surgical planning simulations and real-time navigation systems in surgical procedures involving the anterior, middle, and posterior cranial skull bases, including endoscopic and open microsurgical operations. We also evaluate their influence on surgical decision-making, performance, and education. Accumulating evidence demonstrates that these technologies can enhance the visibility of the neuroanatomical structures situated at the cranial base and assist surgeons in preoperative planning and intraoperative navigation, thus showing great potential to improve surgical results and reduce complications. Maximum effectiveness can be achieved in approach selection, patient positioning, craniotomy placement, anti-target avoidance, and comprehension of spatial interrelationships of neurovascular structures. Finally, we present the obstacles and possible future paths for the broader implementation of these groundbreaking methods in neurosurgery, highlighting the importance of ongoing technological advancements and interdisciplinary collaboration to improve the accuracy and usefulness of 3D visualization and reality technologies in skull base surgeries.

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Section: Anterior Skull Base Surgerymentioning

confidence: 99%

Narrative review of patient-specific 3D visualization and reality technologies in skull base neurosurgery: enhancements in surgical training, planning, and navigation

Isikay,

Cekic,

Baylarov

et al. 2024

Front. Surg.

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Feasibility of Optical Biopsy During Endoscopic Sinus Surgery With Confocal Laser Endomicroscopy: A Pilot Study

Frenken,

Sievert,

Panuganti

et al. 2024

The Laryngoscope

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ObjectiveConfocal laser endomicroscopy (CLE) is an optical imaging technique that allows in vivo, real‐time, microscope‐like assessment of superficial lesions. Although there is substantial data on CLE use in the upper GI tract, there is limited information regarding its application in the nasal cavity and paranasal sinuses. This study aims to assess the feasibility and diagnostic metrics of CLE in the nasal cavity and paranasal sinuses regarding differentiation between healthy/benign and malignant tissue. These structures show, however, a wider variety of frequent and concomitant benign and malignant pathologies, which could pose an increased challenge for optical biopsy by CLE.MethodsWe performed CLE on a case series of six patients with various findings in the nose (three chronic rhinosinusitis, adenocarcinoma, meningoenzephalozele, esthesionneuroblastoma). Forty‐two sequences (3792 images) from various structures in the nasal cavity and/or paranasal sinuses were acquired. Biopsies were taken at corresponding locations and analyzed in hematoxylin and eosin staining as a standard of reference. Three independent examiners blinded to the histopathology assessed the sequences.ResultsHealthy and inflamed mucosa could be distinguished from malignant lesions with an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 84.1%, 85.4%, 83.1%, 72.5%, and 92.1%, respectively, with a substantial agreement between raters (Fleiss κ = 0.62).ConclusionThis technique shows, despite its limitations, potential as an adjunctive imaging technique during sinus surgery; however, the creation of a scoring system based on reproducible and defined characteristics in a larger more diverse population should be the focus of further research to improve its diagnostic value and clinical utility.Level of EvidenceNA Laryngoscope, 2024

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Understanding frozen section histopathology in Sinonasal and anterior skull base malignancy and proposed reporting guidelines

Cited by 2 publications

References 11 publications

Narrative review of patient-specific 3D visualization and reality technologies in skull base neurosurgery: enhancements in surgical training, planning, and navigation

Narrative review of patient-specific 3D visualization and reality technologies in skull base neurosurgery: enhancements in surgical training, planning, and navigation

Feasibility of Optical Biopsy During Endoscopic Sinus Surgery With Confocal Laser Endomicroscopy: A Pilot Study

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