Neurosurgery: Recent Advances and New Perspectives in Skull Base Approaches

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 20 August 2025 | Viewed by 315

Special Issue Editors


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Guest Editor
Department of Neurosurgery, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, University of Paris, 75010 Paris, France
Interests: skull base; chordomas; neuroanatomy; neuro-oncology

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Guest Editor Assistant
Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
Interests: skull base; neuroanatomy; functional neurosurgery; brain tumors; MISS

Special Issue Information

Dear Colleagues,

It would not be incorrect to say that neurosurgery is now facing its greatest era of expansion, for two reasons: the first is that we believe more and more in future generations, and the second is that neurosurgery is intimately connected to innovation and improvement.

The management of skull base lesions in our patients requires a deep understanding of anatomy and remarkable interdisciplinarity at the interface with advanced technologies. Neuro-navigation, now firmly established in our clinical practice, is increasingly combined with augmented reality and machine learning. Artificial intelligence enhances our skills before, during, and after surgery. The use of the endoscope and, more recently, the introduction of the 3D exoscope is becoming increasingly valuable in clinical practice, particularly when applied to the latest minimally invasive approaches, such as the transorbital approach.

The goal of this Special Issue is to gather the best contributions in the field of new technologies applied to neurosurgery, creating a bridge between well-established aspects like surgical neuroanatomy and the essential study of cadavers, which is increasingly enhanced and supplemented by augmented reality. It is also the aim of this Special Issue to address how all these aspects, including the in-depth study of surgical indications for such complex lesions within the so-called onco-functional balance, which minimizes complications, are applied to complex skull base approaches. These range from standard to more advanced techniques, including microsurgery, endoscopy, and even exoscopy.

Topics will include the following:

Skull base surgery;
Brain tumors;
Augmented reality;
Exoscope;
New technologies in neurosurgery.

Prof. Dr. Sèbastien Froelich
Guest Editor

Dr. Matteo De Simone
Guest Editor Assistant

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Keywords

  • skull base
  • neuroanatomy
  • tumors
  • augmented reality
  • ETOA
  • EEA
  • exoscopy
  • endoscopy
  • multi-portal approaches

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Published Papers (1 paper)

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Research

11 pages, 3350 KiB  
Article
The T-Top Technique for Tandem Lesions: A Single-Center Retrospective Study
by Daniele Giuseppe Romano, Raffaele Tortora, Matteo De Simone, Giulia Frauenfelder, Alfredo Siani, Ettore Amoroso, Gianpiero Locatelli, Francesco Taglialatela, Gianmarco Flora, Francesco Diana and Renato Saponiero
J. Clin. Med. 2025, 14(9), 2945; https://doi.org/10.3390/jcm14092945 - 24 Apr 2025
Viewed by 133
Abstract
Background: Tandem Lesions (TLs) or Tandem Occlusions (TOs) are characterized by simultaneous high-grade stenosis or occlusion of the proximal extracranial internal carotid artery and the intracranial terminal internal carotid artery or its branches. These lesions can result in stroke and pose significant [...] Read more.
Background: Tandem Lesions (TLs) or Tandem Occlusions (TOs) are characterized by simultaneous high-grade stenosis or occlusion of the proximal extracranial internal carotid artery and the intracranial terminal internal carotid artery or its branches. These lesions can result in stroke and pose significant challenges to endovascular treatment. This study introduces and evaluates the “T-Top technique” as an innovative approach to address TLs, assessing its safety and technical efficacy. Methods: Data from acute ischemic stroke (AIS) patients treated with the T-Top technique between September 2022 and September 2023 were retrospectively analyzed. The technique involves using the pusher wire of a stent retriever as a microwire to guide a monorail angioplastic balloon to the extracranial carotid stenosis, performing angioplasty simultaneously with stent retriever anchorage. Clinical outcomes, procedural data, and safety were assessed. Results: Successful reperfusion (mTICI > 2b) was achieved in 91% of cases, with a median groin puncture to final recanalization time of 50 min. Favorable clinical outcomes (mRS < 3) were observed in 69% of patients, with a low mortality rate of 6% after 90 days. Conclusions: The T-Top technique offers a rapid and reliable strategy for TL treatment, improving reperfusion rates and clinical outcomes. Further studies are warranted to validate its efficacy in larger cohorts. This technique holds promise for enhancing endovascular treatment outcomes in patients with Tandem Lesions. Full article
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