Endoscopic Approaches to the Skull Base: The Coronal Plane
Bibliographic record
Abstract
Background: Endoscopic endonasal skull base surgery has become an important part of the arsenal of contemporary skull base surgery. The coronal or paramedian plane is defined as the region lateral to the internal carotid artery (ICA) as it courses along the ventral skull base. The endoscopic approaches performed in the coronal plane for paramedian pathology are the most complex of the expanded extrasellar procedures. Method: We reviewed our experience with over 1,000 patients who underwent fully endoscopic expanded endonasal skull base surgery. In this report, we describe a modular system organized around the course of the ICA oriented in the anterior, middle, and posterior coronal planes. Results: The anterior coronal plane has an intimate relation with the anterior fossa and orbit, the mid-coronal plane with the middle fossa and temporal lobe and the posterior coronal plane with the posterior fossa and jugular foramen. The middle and posterior paramedian approaches are further divided in 7 modular zones based on the anatomy of the ICAs. Conclusion: The standardization of anatomic modular approaches to the skull base in the coronal plane simplifies the complexity of accessing paramedian lesions through a midline endonasal corridor optimizing the surgical strategy and, consequently, outcomes. The standardization of modular approaches herein provides for a systematic way of approaching segments via individual or combined endoscopic endonasal corridors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".