Observational studyWorld neurosurgery2021
CSF Rhinorrhoea After Endonasal Intervention to the Skull Base (CRANIAL) - Part 1: Multicenter Pilot Study.
Observational study in World neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Reported outcomes in transsphenoidal surgery for pituitary adenomas: a systematic review.Pituitary · 2023Pooled it
- Skull base reconstruction strategy for high-flow CSF leaks during EEA surgery based on the quality of pedicled nasoseptal flap.Scientific reports · 2026Article
- Continuous white-light/indocyanine green overlay endoscopy in pituitary adenoma surgery: A prospective feasibility and safety study.Brain & spine · 2026Article
- Article
- Biphenotypic Sinonasal Sarcoma: Literature Review of a Peculiar Pathological Entity-The Neurosurgical Point of View.Cancers · 2024Review
- The impact of obesity on rates of post-operative CSF leak following endoscopic skull base surgery: results from a prospective international multi-centre cohort study.Frontiers in endocrinology · 2024Article
- Current and Future Advances in Surgical Therapy for Pituitary Adenoma.Endocrine reviews · 2023Article
- Article
- Machine learning driven prediction of cerebrospinal fluid rhinorrhoea following endonasal skull base surgery: A multicentre prospective observational study.Frontiers in oncology · 2023Article
- Historical and future trends in emergency pituitary referrals: a machine learning analysis.Pituitary · 2022Article
- Sinonasal outcomes associated with the use of BioGlue® in endoscopic transsphenoidal pituitary surgery.Neurosurgical review · 2022Article
- CSF rhinorrhoea after endonasal intervention to the skull base (CRANIAL): A multicentre prospective observational study.Frontiers in oncology · 2022Article
- Closure strategy for endoscopic pituitary surgery: Experience from 3015 patients.Frontiers in oncology · 2022Article
- Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know.Frontiers in oncology · 2022Review
- Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection.Pituitary · 2021Article
- Endoscopic Reconstruction of Skull Base Defects Using Tutoplast.Allergy & rhinology (Providence, R.I.)Article
Corrections and comments
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Authors and funding
1 author at 18 institutions in 1 country.
Funding
Abstract
backgroundCRANIAL (CSF Rhinorrhoea After Endonasal Intervention to the Skull Base) is a prospective multicenter observational study seeking to determine 1) the scope of skull base repair methods used and 2) corresponding rates of postoperative cerebrospinal fluid (CSF) rhinorrhea in the endonasal transsphenoidal approach (TSA) and the expanded endonasal approach (EEA) for skull base tumors. We sought to pilot the project, assessing the feasibility and acceptability by gathering preliminary data.
methodsA prospective observational cohort study was piloted at 12 tertiary neurosurgical units in the United Kingdom. Feedback regarding project positives and challenges were qualitatively analyzed.
resultsA total of 187 cases were included: 159 TSA (85%) and 28 EEA (15%). The most common diseases included pituitary adenomas (n = 142/187), craniopharyngiomas (n = 13/187). and skull base meningiomas (n = 4/187). The most common skull base repair techniques used were tissue glues (n = 132/187, most commonly Tisseel), grafts (n = 94/187, most commonly fat autograft or Spongostan) and vascularized flaps (n = 51/187, most commonly nasoseptal). These repairs were most frequently supported by nasal packs (n = 125/187) and lumbar drains (n = 20/187). Biochemically confirmed CSF rhinorrhea occurred in 6/159 patients undergoing TSA (3.8%) and 2/28 patients undergoing EEA (7.1%). Four patients undergoing TSA (2.5%) and 2 patients undergoing EEA (7.1%) required operative management for CSF rhinorrhea (CSF diversion or direct repair). Qualitative feedback was largely positive (themes included user-friendly and efficient data collection and strong support from senior team members), demonstrating acceptability.
conclusionsOur pilot experience highlights the acceptability and feasibility of CRANIAL. There is a precedent for multicenter dissemination of this project, to establish a benchmark of contemporary practice in skull base neurosurgery, particularly with respect to patients undergoing EEA.
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