Skull base surgery prediction tools

Key terms

• Craniopharyngioma

  Craniopharyngioma is a benign but locally aggressive sellar and suprasellar tumor arising from Rathke pouch remnants. Surgery risks pituitary and hypothalamic injury; recurrence is common.

• Diabetes insipidus after sellar surgery

  Central diabetes insipidus after sellar surgery is a deficiency of vasopressin that causes large volumes of dilute urine. It can be transient, triphasic or permanent.

• Extent of resection

  Extent of resection describes how much tumor was removed: gross-total (no visible residual), near-total (a small remnant) or subtotal (a larger remnant). It trades tumor control against surgical risk.

• Tuberculum sellae meningioma

  A tuberculum sellae meningioma arises just in front of the pituitary fossa and typically compresses the optic nerves and chiasm, presenting with progressive visual loss.

• Endoscopic endonasal approach

  The endoscopic endonasal approach reaches the skull base through the nose and sphenoid sinus using an endoscope, avoiding brain retraction but carrying a risk of CSF leak.

• SHAP (Shapley additive explanations)

  SHAP explains an individual prediction by splitting it into contributions from each input feature, based on Shapley values from game theory.

• Nash bargaining solution

  The Nash bargaining solution picks the option that maximizes the product of each party's gain. In surgery it can balance competing goals such as tumor control and safety.