7:30 AM: Updates in Management for Melanoma

Audiences can expect to learn about the latest advancements in the systemic treatment of sinonasal mucosal melanoma, including recent clinical trials and new treatment modalities.

At the conclusion of this session, attendees will be able to…

• Understand the recent advancements in systemic therapy for sinonasal malignancy, including predictors of response.
• Evaluate the efficacy of immunotherapy and induction chemotherapy.
• Discuss evolving treatment modalities of mucosal melanoma, including non-checkpoint immunotherapy.

7:30 AM Chemotherapy, Immunotherapy and Targeted Therapy for Mucosal Melanoma
7:40 AM Management of the Primary Tumor and Neck – The Extent of Surgery and Radiotherapy
7:50 AM The Frontiers: Genomics, Microbiome, and Novel Therapies
8:00 AM Case Presentation & Discussion: Melanoma
8:10 AM Case Presentation & Discussion: Melanoma – Neoadjuvant Immunotherapy and Radiotherapy
8:20 AM Q&A

8:35 AM: Management Strategies for Advanced Sinonasal Adenoid Cystic Carcinoma

This session will explore the challenges in managing T4b disease, including the extent of surgery and the integration of multimodal therapies.

At the conclusion of this session, attendees will be able to…

• Understand the biology and genomics of sinonasal minor salary gland tumors, such as ACC subclassfication, adenocarcinoma and variants, etc.
• Understand how we balance aggressive resection with the aggressive natural history.
• Understand how should you manage the carotid artery and perineural spread.
• Discuss surgery versus radiation therapy options (neutrons/protons/carbon ion).

10:05 AM: Update on Olfactory Neuroblastoma and Neuroendocrine Tumors

Attendees will be briefed on the multidimensional management of olfactory neuroblastoma, covering aspects from staging and surgery to chemotherapy and radiation.

At the conclusion of this session, attendees will be able to…

• Understand the biological spectrum of olfactory neuroblastoma and sinonasal tumors of neuroendocrine differentiation.
• Understand indications for elective management of the N0 necks.
• Discuss various systemic therapy options for olfactory neuroblastoma and tumors of neuroendocrine differentiation.

11:10 AM: What is Next Following Induction Chemotherapy for SCC and SNUC?

The session will focus on the pathways of care following induction chemotherapy, assessing how to choose subsequent treatments and the considerations impacting these choices.

At the conclusion of this session, attendees will be able to…

• Assess criteria for selecting post-induction chemotherapy treatments.
• Review evidence guiding the extent of resection post-chemotherapy.
• Discuss benefits/drawbacks of post-chemotherapy treatment strategies.

1:20 PM: Benign Tumors

This session will provide an overview of the management of benign tumors at the skull base, focusing on surgical approaches and determining the approach for treatment. Each talk will comprise a summary of evidence and case presentation.

At the conclusion of this session, attendees will be able to…

• Review management best practices for advanced benign tumors such as Diffuse and recurrent IPs, Osteomas, fibrodysplasia with orbital compression/symptoms, JNA, ameloblastoma.
• Discuss surgical approaches for skull base tumors.
• Evaluate indications/outcomes for conservative vs aggressive surgery.
• Evaluate and manage malignant transformation.

2:25 PM: Invasive Fungal Sinusitis

In this session, participants will learn about the best practices for the management of invasive fungal sinusitis, including the management of orbital involvement and antifungal therapies.

At the conclusion of this session, attendees will be able to…

• Discuss indications and extent for surgical resection in treatment.
• Examine the role of orbital exenteration for disease control, and strategies for orbital preservation including intraorbital antifungal therapy.
• Evaluate effectiveness of topical antifungals in management.

10:05 AM: Facial Nerve Reanimation

Facial nerve reanimation is critical to many lateral skull-base cases. This will be a case-based panel discussion of treatment algorithms for these challenging cases.

At the conclusion of this session, attendees will be able to…

• Articulate different facial nerve deficits and the priority of the resulting morbidity.
• Integrate different treatment algorithms and optimize timing of reconstruction.
• Demonstrate the long-term results and complications related to facial nerve deficits and treatment.

10:05 AM Reconstruction of Delayed Onset Paralysis
10:15 AM Reconstruction of Acute Facial Nerve Defect
10:25 AM Adjunctive Therapies: Do They Do Anything and When Should We Do It?
10:35 AM International Perspective on Facial Reanimation
10:45 AM Facial Nerve Board
11:00 AM Q&A

11:10 AM: Osteoradionecrosis and Carotid Blowout: Recon for Dreaded Delayed Complications

Radiotherapy and osteoradionecrosis pose significant issues for surgical extirpation and reconstruction. This will be a case-based panel presenting common complicated scenarios for the extirpative and reconstructive surgeon to highlight the pre and post – operative decision making process.  This session will also discuss evidence behind medical therapy and HBO.

At the conclusion of this session, attendees will be able to…

• Understand the risk of various radiation wounds leading to carotid blowout.
• Understand the evidence and use of medical therapy and HBO for ORN.
• Understand the various treatment algorithms for treatment and prevention.

1:20: PM: Videos and Virtual Planning: Complex Scalp/Midface/Anterior Cranial-Based Defect Reconstruction

Complex scalp/midface/anterior cranial based defects pose challenges to reconstructive teams. This will be a case-based panel discussion with 4 panelists presenting cases and reconstructive algorithms and technology used to assist. An emphasis will be placed on short video clips of medical modeling and intraoperative techniques.

At the conclusion of this session, attendees will be able to…

• Classify various complex defects and differentiate the hierarchy of wounds to be reconstructed.
• Understand different reconstructive algorithms for complex defects.
• Understand the impact of radiotherapy in reconstructive decision making.
• Apply virtual planning as a tool to aid in complex tumor extirpation and reconstruction.
• Understand aesthetic implications and interventions from an oculoplastic perspective (i.e. temporalis fossa hollow, temporalis muscle contraction, persistent proptosis, etc)

2:25: PM: Locoregional vs Free Flap Reconstruction Debate

Complex skull base defects often have options for reconstruction. Two cases will be presented with an ensuing debate for locoregional versus free flap reconstruction. 2 cases – One pro-locoregional point, One pro-free flap point Counter for each. Audience poll before and after.

At the conclusion of this session, attendees will be able to…

• Understand the advantages and disadvantages of locoregional and free flap.
• Evaluate different defects and algorithms for reconstruction.
• Identify and manage various complications related to the different defects and treatments.

7:30 AM: Part 1: Sinus, Eyes, Ears Surgical Localization, Advanced Imaging Techniques

This advanced neuroradiology is for all clinicians with a more detailed imaging review and analysis of imaging anatomy and pathology in the paranasal sinus, orbits and temporal bone. In addition, this course will present more advanced imaging.

At the conclusion of this session, attendees will be able to…

• Articulate and assess imaging anatomy and pathology in the paranasal sinus, orbits and temporal bone.
• Assess and evaluate how PET, dual energy CT, pituitary photon CT are utilized to help evaluate skull base pathology, and pitfalls and diagnostic errors in the skull base.
• Infer how to utilize advanced imaging techniques to diagnose CSF leaks, as well as how high field MRI and spectroscopy can be utilized to differentiate skull base lesions, and techniques for tumor segmentation.

08:10 AM Pituitary Photon CT
08:20 AM Q&A
08:30 AM Learning from Misses and Mistakes in the Skull Base
08:40 AM MRI Imaging of Skull Base and Spine with Bone Window Sequences
08:50 AM Advanced Imaging Techniques CSF Leaks Skull Base with MRI
09:00 AM Advanced Imaging Techniques for Pediatric Skull Base Pathology
09:10 AM Advanced Skull Base Neoplasm, Segmentation Skull Base
09:20 AM Q&A

10:05 AM: Part 2: Photon Counting CT – DECT

This advanced neuroradiology is for all clinicians with a focus on how skull base protocols can be optimized for cross-sectional imaging on CT and MRI, advanced techniques with 3D printing, advanced PET CT tricks and tips, and ultra-high field 11.7 T MRI, artificial intelligence, and quality imaging improvement, as well as the importance of surgical localization with minimally-invasive approaches.

At the conclusion of this session, attendees will be able to…

• Employ techniques to optimize skull base imaging in CT and MRI, and 3D printing for skull base pathologies.
• Recognize how PET CT can help differentiate skull base lesions and assess how artificial intelligence and genetics are utilized to assess skull base pathology.
• Evaluate tools used radiographically for surgical localization and for teaching of skull base pathologies.

10:05 AM Introduction
10:10 AM Optimizing Skull Base Imaging Protocols on CT
10:20 AM Optimizing Skull Base Imaging Protocols on MRI
10:30 AM Advanced Imaging Techniques with 3D Printing
10:40 AM Advances in AI Radiology for Evaluation of the Skull Base
10:50 AM Advanced AI Applications in Skull Base and Spine Imagining
11:05 AM Q&A
11:15 AM Basics of AI Applications in Radiology
11:25 AM Utilization of AI, Podcasts, and Social Media for Education
11:35 AM Advanced Imaging Techniques Surgical Localization – Imaging for TORS
11:45 AM When a Skull Base Case Seems Extraordinary – How to Think Through It
11:55 AM Q&A

1:20 PM: Part 3: Curtain Call Lecture and Skull Base Imaging

This session further provides pearls from internationally-recognized expert neuroradiologists for all clinicians.

At the conclusion of this session, attendees will be able to…

• Articulate and assess imaging anatomy and pathology in the paranasal sinus, orbits and temporal bone.
• Assess and evaluate how PET, dual energy CT, pituitary photon CT are utilized to help evaluate skull base pathology, and pitfalls and diagnostic errors in the skull base.
• Infer how to utilize advanced imaging techniques to diagnose CSF leaks, as well as how high field MRI and spectroscopy can be utilized to differentiate skull base lesions, and techniques for tumor segmentation.

1:20 PM Introduction
1:25 PM Curtain Call Lecture: Skull Base Imaging – Seeing the Future, Improving Quality & Avoiding Diagnostic Skull Base Errors
1:50 PM Skull Base Neuro Interventional Pearls
1:58 PM Pediatric Skull Base Pathology – Key Cases and Variants
2:06 PM Radiographic Skull Base Pathology vs Don`t Touch Lesions
2:14 PM Q&A

1:20 PM: Stereotactic Radiation Therapy at Skull Base

This section of the course will focus on stereotactic radiation therapy applications for skull base tumors evaluating the latest available technologies, including proton- and LINAC-based therapies. This course is targeted at neurosurgeons, neurotologists.

At the conclusion of this session, attendees will be able to…

• Demonstrate knowledge on indications for radiosurgery at the skull base.
• Discuss the expected outcomes in individual patients and potential range of complications after skull base radiotherapy/radiosurgery.
• Apply the principles of stereotactic radiotherapy imaging, target delineation, dose planning and motion management for day-to-day management of skull base tumors.

4:00 PM: Course Practical – Case Presentation/Planning
This is the case-based practical portion of the course designed for those interested in contouring and dose planning including residents, fellows, practicing neurosurgeons and radiation oncologists and physicists. Cases will be presented and treatment app.

At the conclusion of this session, attendees will be able to…

• Apply the principles of stereotactic radiotherapy imaging, target delineation, dose planning and motion management for day-to-day management of skull base tumors.
• Perform and evaluate dose painting delineation and dose planning of often encountered challenging skull base tumors.
• Understand the advantages and disadvantages of various stereotactic radiosurgery approaches and decide on optimal dose-fractionation.

7:30 AM: Surgical Management of Vestibular Schwannoma: Technical Considerations and Operative Decision-Making

This session focuses on the management and operative considerations for vestibular schwannoma surgery.

At the conclusion of this session, attendees will be able to…

• Learn up to date surgical techniques for the most common surgical approaches for the management of vestibular schwannomas.
• Discuss modern management amongst a group of international and north American surgeons.
• Evaluate modern techniques in the management of small, medium and giant vestibular schwannomas.

8:35 AM: Emerging Research on Vestibular Schwannoma

Talks on upcoming and ongoing clinical trials for treatment of recurrent acoustic neuromas – both sporadic and associated with NF2.

At the conclusion of this session, attendees will be able to…

• Identify clinical trials ongoing for vestibular schwannomas and NF2.
• Recognize eligible patients for vestibular schwannoma clinical trials.
• Demonstrate the benefit of vestibular schwannoma clinical trials.

08:35 AM Introduction
08:37 AM Update on ASA Clinical Trial
08:47 AM Upfront Radiosurgery vs a Wait-and-Scan Approach for Small- or Medium-Sized Vestibular Schwannoma: The V-REX Randomized Clinical Trial
08:57 AM Single-cell Multi-Omic Analysis of the Vestibular Schwannoma Ecosystem Uncovers a Nerve Injury-Like State
09:07 AM Fluorescein in Vestibular Schwannoma Surgery
09:17 AM International Trial
09:27 AM Q&A

10:05 AM: Minimally Invasive Approaches to Vestibular Schwannoma

This session will focus on recently described minimally invasive approaches to acoustic neuromas included approaches through the EAC and with the use of the endoscopic for select cases.

At the conclusion of this session, attendees will be able to…

• Identify cases for which a minimally invasive approach may be appropriate.
• Understand evidence for advances in minimally invasive surgical technique.

11:10 AM: Evolving Technology in the Treatment of Vestibular Schwannoma Patients

This session will focus on the use of new technology in the treatment of acoustic neuroma patients. This includes the use of wearable technology for tracking outcome, improvements in the use of endoscopic surgery, and improvements in tractography and advanced AI in radiology.

At the conclusion of this session, attendees will be able to…

• Discuss new technologies being applied in management and rehabilitation of vestibular schwannoma.
• Recognize gaps in treatment or rehabilitation that have prompted innovative new technologies for patients with vestibular schwannoma.
• Identify limitations of new technology for care of patients with vestibular schwannoma.

11:10 AM Introduction
11:12 AM Use of Wearable Devices to Assess Vestibular Function in Vestibular Schwannoma Patients
11:20 AM Three-dimensional (3D) Printed Vestibular Schwannoma for Facial Nerve Tractography Validation
11:28 AM Automatic Segmentation of Vestibular Schwannomas
11:36 AM An External Validation Study for Automated Segmentation of Vestibular Schwannoma
11:44 AM Case Report: Use of Novel AR Registration System for Presurgical Planning During Vestibular Schwannoma Resection Surgery
11:52 AM Accuracy and Outcomes of Diffusion Tensor Imaging Tractography in Resection for Vestibular Schwannoma for Facial Nerve Preservation
12:00 PM Q&A

1:20 PM: Vestibular Schwannoma Cases: What Would I Have Done (Vestibular Schwannoma)

This session will focus on lessons learned during cases from vestibular schwannoma surgery experts.

At the conclusion of this session, attendees will be able to…

• Identify difficult situations that can arise during acoustic neuroma surgical management and discuss appropriate management.
• Identify difficult situations that can arise during acoustic neuroma stereotactic radiation treatment and discuss appropriate management.
• Identify difficult situations that can arise during acoustic neuroma observation and discuss appropriate management.

7:30 AM: The Surgical Management of Clival Chordoma at Initial Presentation

Expert panel discussion on the management of newly diagnosed clival chordoma cases. Lecture topics include 1) radiology of clival pathology; 2) endoscopic approach pearls and nuances; 3) open surgical approaches to the clivus; and 4) reconstruction of clival defects. Intended for neurosurgeons otolaryngologists, radiation oncologists and radiologists.

At the conclusion of this session, attendees will be able to…

• Articulate key findings on imaging that suggest chordoma.
• Identify key factors that are useful in determining endoscopic versus open approaches.
• Recommend operative strategies for management of primarily diagnosed chordoma.

8:35 AM: First-Line Adjuvant Therapy for Clival Chordoma

This session reviews and discusses optimal postoperative adjuvant therapy management of newly diagnosed clival chordoma cases. Intended for neurosurgeons, otolaryngologists, pathologists, radiation oncologists, medical oncologists.

At the conclusion of this session, attendees will be able to…

• Understand the basic pathologic findings in chordoma, as well as the foundational molecular biology.
• Identify options for postop adjuvant therapy, as well as options when surgical resectability is limited.
• Differentiate pros and cons for IMRT, SRS, proton beam and carbon ion radiotherapy.

10:05 AM: Clival Chordoma: Complication Management, Survivorship and Promising Future Treatment

The discussion will focus on complication management and promising treatments in chordoma. Discussions will include: 1) management of abducens palsy; 2) reconstruction techniques after radiation therapy; 3) update on chordoma research; and 4) review of potential targeted molecular and immune therapies. Intended for neurosurgeons, otolaryngologists, medical oncologists, radiation oncologists.

At the conclusion of this session, attendees will be able to…

• Describe common surgical complications of chordoma.
• Discuss options for management of orbital complications and other survivorship issues in chordoma care.
• Appraise groundbreaking research in chordoma, include benchwork and new clinical trials.

11:10 AM: Management of Recurrent Clival Chordoma – What Are My Options

This session reviews and discusses management of recurrent clival chordoma cases that have had prior surgical and radiation therapy. Discussion will include 1) summary of clival chordoma outcome studies; 2) surgical considerations of recurrent clival chordoma; and 3) survivorship resources by the Chordoma Foundation. Intended for neurosurgeons, otolaryngologists, radiation oncologists, medical oncologists.

At the conclusion of this session, attendees will be able to…

• Summarize the literature regarding clival chordoma outcomes.
• Identify options for treating recurrent clival chordoma.
• Articulate unique considerations for operative intervention for recurrent clival chordoma.

1:20: PM: Pediatric Clival Chordoma: Surgical and Adjuvant Therapy Considerations

The discussion will focus on the unique management considerations of pediatric clival chordoma cases,  including: 1) pathological/biological considerations of pediatric clival chordoma, 2) unique surgical management considerations and 3) unique radiation treatment considerations. Intended for neurosurgeons, otolaryngologists, medical oncologists, radiation oncologists, radiologists, researchers.

At the conclusion of this session, attendees will be able to…

• Describe the unique biological considerations in pediatric chordoma.
• Identify challenges in surgical management of pediatric chordoma and strategies for risk mitigation.
• Identify challenges in radiation treatment for pediatric chordoma and strategies for risk mitigation.

8:35 AM: Career Building – Research Committee: Physician Scientist Pathways

The pathway to becoming a physician-scientist can be a challenge and there are many potential pathways to success. The goal of this session is designed for aspiring and early-career physician-scientists. We will focus on making the audience aware of non-traditional pathways and funding opportunities to facilitate their success. We will discuss common challenges including start-up time, setting boundaries, and balancing clinical goals with productive research.

At the conclusion of this session, attendees will be able to…

• Identify successful `out of the box` tracks in research.
• Utilize your research time and resources effectively.
• Discuss pearls and pitfalls (setting boundaries, balancing clinical targets and research production goals, etc).
• Explore opportunities for non-NIH funding and support.

11:10 AM: Skull Base Surgery Around the World – Past, Present, and the Future
Room: Bayside A, 4th Floor

There has been significant progress in the field of skull base surgery over the last 50 years. This session highlights the evolution of skull base surgery as a specialty from a societal, collaborative and international perspective.

At the conclusion of this session, attendees will be able to…

• Describe the evolution of the North American Skull Base Society, it’s past, present, and potential future directions.
• Describe the nuances of the retrosigmoid approach for Vestibular Schwannoma.
• Discuss oncological outcomes for sinonasal malignancies in a large, multicenter, international cohort of patients treated with surgery over the past two decades.

2:25 PM: AI/Technology – What is AI

Understand the basic concepts of artificial intelligence (AI) and its applications in surgery.

At the conclusion of this session, attendees will be able to…

• Evaluate the currently available AI systems for surgical research and care.

4:00 PM: Career Building – Women in Skull Base Surgery: Building Your Team for Success. Followed by a networking reception.

As we progress in our careers, we have the opportunity to build our own team. While being a leader can be quite advantageous and beneficial, the responsibility can be daunting. Surrounding ourselves with the right people who can balance out our weaknesses and provide appropriate guidance is of paramount importance for personal and team success. Here we discuss strategies for anyone interested in how to successfully build and lead a team, both in the clinical and non-clinical settings, to ensure excellence and provide valuable insight for avoiding pitfalls.

At the conclusion of this session, attendees will be able to…

• Learn strategies for how to identify and fulfill team needs to enhance productivity.
• Develop methods to balance mentoring more junior colleagues/trainees while achieving milestones for your own career advancement/ promotion.
• Identify common pitfalls that deter successful team leadership.

5:05 PM: AI/Technology – The Role of AI in Skull Base Clinical Practice and Training

This session explores the current and future role of Artificial Intelligence (AI) in skull base training. Intended for surgeons who want to maximize their self improvement as well as academic surgeons aiming to optimizing trainee education.

At the conclusion of this session, attendees will be able to…

• Describe the capabilities of artificial intelligence (AI) in augmenting human knowledge by accelerating learning and retention.
• Demonstrate how AI can be used to scale surgical mentorship and enhance personal and global surgical skill development.

7:30 AM: International NASBS/WFSBS Collaboration Operative Video Session: Anterior Skull Base

This session focuses on disorders of the anterior skull base including both endoscopic and microscopic approaches. Operative video sessions demonstrating the management and technical considerations for surgical cases are to be presented and discussed.

At the conclusion of this session, attendees will be able to…

• Learn up to date surgical techniques in the management of anterior skull base disorders such as craniopharyngioma, pituitary adenoma and meningioma.
• Discuss modern management amongst a group of international and north American surgeons.
• Evaluate modern endoscopic techniques utilized in the management of anterior skull base disorders.

8:35 AM: International NASBS/WFSBS Collaboration Operative Video Session: Vascular and Posterior Fossa

This session focuses on disorders of the posterior fossa and vascular disorders. Operative video sessions demonstrating the management and technical considerations for surgical cases are to be presented and discussed.

At the conclusion of this session, attendees will be able to…

• Learn up to date surgical techniques in the management of posterior fossa skull base disorders such as meningioma, pineal region, and brainstem.
• Discuss modern management amongst a group of international and north American surgeons.
• Learn up-to-date surgical techniques in the management of vascular disorders, including giant aneurysms, transcavernous approaches, and paraclinoid aneurysms.

10:05 AM: International NASBS/WFSBS Collaboration Operative Video Session: Lateral Skull Base

This session focuses on disorders of the anterior skull base including both endoscopic and microscopic approaches. Operative video sessions demonstrating the management and technical considerations for surgical cases are to be presented and discussed.

At the conclusion of this session, attendees will be able to…

• Learn up to date surgical techniques in the management of lateral skull base disorders such as vestibular schwannoma and meningioma.
• Discuss modern management amongst a group of international and north American surgeons.
• Evaluate modern endoscopic techniques utilized in the management of lateral skull base disorders.

11:10 AM: Video Abstracts
1:20: PM: Video Abstracts
4:00 PM: Video Abstracts

7:30 AM: Proffered Papers 01 – Pituitary Extrasellar Extension
7:30 AM: Proffered Papers 02 – Translational Science & Miscellaneous
8:35 AM: Proffered Papers 03 – Pituitary Hormone Secreting
10:05 AM: Proffered Papers 04 – Pituitary 1
11:10 AM: Proffered Papers 05 – Pituitary 2
1:20 PM: Proffered Papers 06 – Reconstruction
2:25 PM: Proffered Papers 07 – Chordoma
2:25 PM: Proffered Papers 08 – Other 1
2:25 PM: Proffered Papers 09 – Anterior Skull Base 1
4:00 PM: Proffered Papers 10 – Sinonasal Malignancy
4:00 PM: Proffered Papers 11 – CPA / Lateral Skull Base
4:00 PM: Proffered Papers 12 – Craniopharyngioma / Sellar Cysts
4:00 PM: Proffered Papers 13 – International 1
4:00 PM: Proffered Video – Meningioma 1
5:05 PM: Proffered Papers 16 – Sella / Suprasellar
5:05 PM: Proffered Papers 17 – International 2
5:05 PM: Proffered Video – Sinonasal
5:05 PM: Proffered Video – Meningioma 2

7:30 AM: Olfactory Groove Meningiomas: Achieving Optimal Outcome

The session will cover the following topics regarding the management of olfactory groove meningiomas: Role of Open Approaches, Role of Endoscopic Endonasal Approaches, Role of Transorbital, Role of Radiosurgery, Neuropsychological Considerations.

At the conclusion of this session, attendees will be able to…

• Recognize indications and long-term outcomes for open approaches and nuances to maximize surgical outcomes.
• Identify indications for long-term outcomes for endoscopic approaches and nuances to maximize surgical outcomes.
• Apply indications and long-term outcomes for radiosurgery and nuances to maximize outcomes.
• Understand relevant neuropsychological evaluation, impact of and long-term outcomes for patients with olfactory groove meningiomas.

8:35 AM: Tuberculum Meningiomas – What is the Evidence?

This will be a panel-based discussion of cases presented by the moderators. Panelists will be asked to debate various management options and asked to present data to support their point of view. This will be an interactive session where the audience will be polled before and after each case debate.

At the conclusion of this session, attendees will be able to…

• Understand the anatomic limitations of endonasal and open approaches to tuberculum meningiomas.
• Recognize the key nuances of approach selection for tuberculum meningiomas.
• Learn an evidence-based approach for approach selection for tuberculum meningiomas.

1:20 PM: Spheno-Orbital Meningiomas: Management Considerations

This session will cover the following aspects relative to the management of spheno-orbital meningiomas: Indications for Open versus Transorbital Approaches, Molecular Characteristics of Sphenoid Wing/Spheno-orbital Meningiomas, Orbital Reconstruction Considerations, Radiation Considerations with Intraconal Disease, Hormonal Therapy, Impact on Tumor Growth and Role in Management.

At the conclusion of this session, attendees will be able to…

• Recognize the key clinical goals for management of spheno-orbital meningiomas.
• Understand the limitations and advantages of open and transorbital approaches for spheno-orbital meningiomas.
• Learn the molecular underpinnings for osseous involvement of spheno-orbital meningiomas.
• Develop an overall management paradigm for spheno-orbital meningiomas.
• Learn indications for resection of intra-orbital involvement of spheno-orbital meningiomas and indications for reconstruction following resection.

2:25 PM: Complications of Anterior Skull Base Surgery – Open and Endonasal

This session will consist of panelists presenting complications related to anterior skull base surgery with a combination of video presentations, data and management strategies.

• Recognize common sites for failure of skull base reconstruction following endonasal resection of anterior skull base meningiomas.
• Predict common sites for failure of skull base reconstruction following open resection of anterior skull base meningiomas.
• Understand the key vascular structures at risk during resection of anterior skull base meningiomas and discuss techniques for preservation.
• Discuss the pros and cons of attempts at olfactory preservation in the treatment of anterior skull base meningiomas.

4:00 PM: Reconstruction Considerations with Anterior Skull Base Defects

This session will cover the reconstruction nuances after open transcranial, endoscopic endonasal and transfacial approaches to the anterior cranial fossa: Regional Flaps, Free Flaps, Non-Vascularized Reconstruction, Perioperative Management following Anterior Skull Base Reconstruction.

At the conclusion of this session, attendees will be able to…

• Recognize the indications for non-vascularized reconstruction of anterior skull base defects.
• List the vascularized loco-regional flaps used for reconstruction of anterior skull base defects.
• Recognize the advantages and limitations of each loco-regional flap used for reconstruction of anterior skull base defects.
• Discuss the indications and techniques for free flap reconstruction of anterior skull base defects.

7:35 AM: EUSICA/INSICA: Multicentric Collaborative Research in Sinonasal Cancer
The aim of the session is to show what collaborative groups like EUSICA/INSICA can bring to the study of rare cancers such as sinonasal cancers, with a focus on the potential applications of molecular biology in this field.

At the conclusion of this session, attendees will be able to…

• Understand what international multicenter collaborations can bring to the field of rare cancers such as sinonasal cancers, in terms of both basic and translational research, as well as in everyday patient management (PROMs and therapeutic guidelines).
• Understand how the methylation classifier can assist in the diagnostic classification of sinonasal cancers.
• Apply therapeutic stratification tools to improve the management of patients with olfactory neuroblastoma.

07:30 AM Introduction
07:35 AM Contribution of the Methylation Classifier to the Diagnosis of Sinonasal Cancers
07:55 AM Improvement in Stratification of Olfactory Neuroblastoma
08:05 AM Basic and Translational Research in Sinonasal Cancer: Future Directions
08:15 AM PROMs, Comparative Study of International Guidelines: 2 Examples of EUSICA Actions – Outlook and Vision for 2026
08:25 AM Q&A

8:35 AM: Sinonasal Sarcoma Update

This hot topic session will provide and up-to-date review on the pathology, molecular profile, appropriate margins, and timing of resection (post-induction chemotherapy vs post-irradiation) for sinonasal sarcoma.

At the conclusion of this session, attendees will be able to…

• Identify the different pathologic types and mutations associated with sinonasal sarcomas.
• Recognize which patients who would benefit from upfront nonsurgical management of sinonasal sarcoma.
• Select patients who would benefit from surgical resection based on patient factors, tumor characteristics, and treatment response.

08:35 AM Updates in Tumor Classification and Molecular Profiling
08:45 AM The Evidence for Neoadjuvant/Adjuvant Systemic Therapy
08:55 AM Evidence-based RT for Sarcoma
09:05 AM Surgery for Sarcoma: Timing and Margin Negative Resection
09:15 AM Clinical Trials in Sarcoma
09:25 AM Q&A

1:20 PM: State of the Art and Future Directions in the Management of Nasopharyneal Cancer

08:35 AM Updates in Tumor Classification and Molecular Profiling
08:45 AM The Evidence for Neoadjuvant/Adjuvant Systemic Therapy
08:55 AM Evidence-based RT for Sarcoma
09:05 AM Surgery for Sarcoma: Timing and Margin Negative Resection
09:15 AM Clinical Trials in Sarcoma
09:25 AM Q&A

This hot topic session will provide an up to date review of the role of biomarkers as well ongoing clinical trials including induction chemotherapy, immunotherapy, and vaccine trials in the treatment of nasopharyngeal carcinoma.

At the conclusion of this session, attendees will be able to…

• Integrate the use of biomarkers into nasopharyngeal carcinoma treatment.
• Select patients who may benefit from the addition of induction chemotherapy or immunotherapy in the treatment of nasopharyngeal carcinoma.
• Identify patients who may benefit from novel modalities.
• Identify patients who may benefit from de-escalation or reduction in radiotherapy.

1:20 PM The Role of EBV DNA and Biomarkers in Prognostication and Treatment Selection
1:30 PM Chemotherapy – Induction vs Adjuvant: When and Why?
1:40 PM Immunotherapy and Novel Approaches in NPC
1:50 PM IMRT vs Proton Therapy vs Carbon Ion
2:00 PM Quality of Life Considerations in NPC, and Strategies for De-escalation
2:10 PM Q&A

2:25 PM: How I Do It: Salvage Nasopharyngectomy: Open vs Endoscopic vs Robotic

This video session will outline the surgical management of recurrent nasopharyngeal carcinoma and cover the relevant anatomical and clinical considerations when selecting patients for open surgery vs. endoscopic approaches and robotic-assisted approaches.

At the conclusion of this session, attendees will be able to…

• Compare and Contrast open vs endoscopic- or robotic-assist approaches.
• Understand the technical nuances of each approach.
• Recognize which patients might be better treated with re-irradiation.

2:25 PM Introduction
2:26 PM Open Approaches to the Nasopharynx
2:31 PM Endoscopic Approaches to the Nasopharynx
2:41 PM Robotic Approaches to the Nasopharynx
2:51 PM Case Presentation and Panel Discussion
3:01 PM Case Presentation and Panel Discussion
3:11 PM Q&A

4:00 PM: Management of Locally Recurrent Nasopharynx Cancer

This great case-based session will outline modern day radiation techniques and systemic treatment paradigms in locally recurrent NPC.

At the conclusion of this session, attendees will be able to…

• Recognize the challenges with respect to reirradiation of the nasopharynx and surround critical structures.
• Identify the pros and cons of the various radiation modalities used in reirradiation, including anticipated complications.
• Understand strategies for incorporating chemotherapy and systemic therapy into the treatment plan to improve survival and surgical resectability.
• Understand the nuance and limits of surgical salvage and reconstruction.

4:00 PM Reirradiation Modalities: Survival and Toxicity, Pearls and Pitfalls
4:12 PM Strategies to Reduce Recurrence from Endoscopic Nasopharyngectomy
4:22 PM Surgical Salvage – What is the Evidence?
4:32 PM Management of the Carotid Artery in Surgical Resection – Stent, Bypass or Bail?
4:42 PM Reconstruction When There Are No Nasoseptal Flaps
4:52 PM Q&A

5:25 PM: The Great Debate: Surgery vs Radiation for Locally Recurrent and Minor Salivary Gland Nasopharyngeal Cancer

This session will shed light on areas of controversy in the treatment of locally recurrent nasopharyngeal cancer, specifically with respect to decision making around reirradiation vs. salvage surgery treatment. This session will be geared toward members of the multidisciplinary team caring for nasopharyngeal carcinoma: radiation oncologist, medical oncologists, head and neck surgeons, rhinologists and neurosurgeons.

At the conclusion of this session, attendees will be able to…

• Identify patients who would benefit from open surgical approaches in the treatment of recurrent nasopharyngeal cancer.
• Select patients who would benefit from either endoscopic- or robotic-assist approaches.
• Recognize which patients might be better treated with re-irradiation.

5:05 PM: State of the Art and Future Directions in the Management of Nasopharyneal Cancer

This hot topic session will provide an up to date review of the role of biomarkers as well ongoing clinical trials including induction chemotherapy, immunotherapy, and vaccine trials in the treatment of nasopharyngeal carcinoma.

At the conclusion of this session, attendees will be able to…

• Integrate the use of biomarkers into nasopharyngeal carcinoma treatment.
• Select patients who may benefit from the addition of induction chemotherapy or immunotherapy in the treatment of nasopharyngeal carcinoma.
• Identify patients who may benefit from novel modalities.
• Identify patients who may benefit from de-escalation or reduction in radiotherapy.

7:30 AM: Jugular Foramen Paragangliomas: Treatment Indications & Strategies

This session will provide a comprehensive review of state-of-the art strategies for the management of jugular foramen paragangliomas. It will be of interest to all those involved in the interdisciplinary treatment of paraganglioma.

At the conclusion of this session, attendees will be able to…

• Integrate multimodality approaches for the management of jugular foramen paragangliomas.
• Identify novel therapeutic targets in the treatment of paragangliomas in general.
• Recognize the role of interdisciplinary management of jugular foramen paragangliomas.

8:35 AM: Treatment Paradigms for Advanced Temporal Bone Malignancies

Management of temporal bone malignancies is always challenging. This difficult pathology becomes even more difficult with local regional spread of disease. This session will provide an overview of management strategies for high stage temporal bone malignancy, seek to demonstrate safe techniques that will still allow good oncologic outcomes and provide the audience with direction for the management of advanced stage temporal bone malignancy.

At the conclusion of this session, attendees will be able to…

• Discuss the staging system and initial diagnostic evaluation of temporal bone malignancy.
• Discuss optimal multimodal treatment strategies for advanced temporal bone malignancy, including the role for incomplete resection for advanced malignancy of the lateral skull base.
• Review available systemic therapy options for squamous cell carcinoma, basal cell carcinoma, and minor salivary gland tumors, all of which can result in temporal bone malignancy.

1:20 PM: Rare Diseases of the Temporal Bone

This case-based session will provide a multidisciplinary approach to diagnosing and treating uncommon diseases that arise in the lateral temporal bone, including radiographic features, genetic considerations, and illustrative case examples.

At the conclusion of this session, attendees will be able to…

• Diagnose a wide swath of common, uncommon, and rare diseases that are encountered within the lateral temporal bone.
• Prioritize diagnostic tests for definitive diagnosis and preoperative management of rare lateral temporal bone diseases.
• Identify key syndromes associated with rare lateral temporal bone diseases and how their presence may influence the diagnostic and therapeutic strategy.

2:25 PM: The Great Debate: Operative Approaches to the Jugular Foramen

This session will review anatomical, radiographic, and technical aspects of approaching the jugular foramen for lateral skull base diseases.

At the conclusion of this session, attendees will be able to…

• Assess anatomical considerations influencing approach selection for lateral temporal bone operations.
• Construct individualized treatment plans for lateral temporal bone operations.
• Relate the short- and long-term management considerations for patients undergoing lateral temporal bone operations.

4:00 PM: Innovation in Lateral Skull Base

This hot topic session will provide a comprehensive overview of cutting-edge tools and emerging technologies that are anticipated to influence the management of lateral temporal bone diseases, including advanced imaging strategies, medical and immunotherapeutic options, robotics, AI, informatics, and data science, among others.

At the conclusion of this session, attendees will be able to…

• Integrate novel imaging and therapeutic strategies into the clinical management of lateral temporal bone diseases.
• Evaluate emerging tools and techniques that may enhance the work-up and treatment of lateral temporal bone disorders, including AI-based clinical instruments and operative robotics.
• Identify high-yield avenues for the application of innovative tools to skull base trainee education, including AR/VR/MR.

5:05 PM: Petroclival Meningioma Management: Less is More or More is Better?

At the conclusion of this session, attendees will be able to…

Yes, there`s always room for anterior versus combined. In this session, we will discuss approach selection, vascular management, preservation of function, and adjuvant management.

• Interpret imaging characteristics of petroclival meningiomas.
• Develop treatment algorithms for petroclival meningiomas.
• Appropriately manage for petroclival meningiomas.

7:30 AM: Surgical Approaches for Craniopharyngioma

This session will compare and contrast the different surgical options for the management of craniopharyngioma. We will review a variety of different craniopharyngioma types and discuss which strategies may be most effective in each situation.

At the conclusion of this session, attendees will be able to…

• Recognize the variety of surgical approaches to craniopharyngiomas and develop a strategy for appropriately employing such approaches.
• Distinguish the nuances differences in surgical approaches and when to best implement such approaches.

8:35 AM: Nonsurgical Therapy for Craniopharyngiomas

We will review treatment options and potential multimodal therapies for the variety of craniopharyngiomas that one encounters in clinical practice via an interactive Tumor Board format.

At the conclusion of this session, attendees will be able to…

• Recognize the adjuvant therapies available for the management of craniopharyngioma.
• Formulate comprehensive treatment plans for patients with craniopharyngioma with the use of surgical, radiotherapy, and medical adjuncts.

1:20 PM: Expectation Management and Quality of Life Outcomes in Craniopharyngioma

This session will help attendees understand the impact of craniopharyngioma treatment and quality of life outcomes, as well as allow participants to better understand how to counsel their patients preoperatively especially in terms of fertility and pregnancy.

At the conclusion of this session, attendees will be able to…

• Recognize the potential long-term implications of surgery and develop a strategy to convey these to patients in an informative and impactful way.
• Develop a multidisciplinary approach to preoperative counseling of patients with craniopharyngioma.

2:25 PM: Craniopharyngioma Tumor Board

This session will review treatment options and potential multimodal therapies for the variety of craniopharyngiomas that one encounters in clinical practice via an interactive Tumor Board format.

At the conclusion of this session, attendees will be able to…

• Develop and implement an appropriate treatment paradigm for the management of an array of craniopharyngiomas.
• Create a consensus management plan using the input of a multidisciplinary team.vvvv

4:00 PM: My Most Challenging Craniopharyngioma Case Video Session

This will be a high quality video review of the technical aspects of the surgical management of craniopharyngioma. Emphasis will be on surgical pearls and techniques which will be demonstrated in video format. Speaker will present a video, moderators ask questions, speakers and panelists all discuss.

At the conclusion of this session, attendees will be able to…

• Recognize the nuanced surgical pearls from experts in the field as illustrated by challenging cases.
• Use imaging to predict challenges or complications (intraop or postop).
• Predict challenges in reconstruction.

7:30 AM: Career Building – Beyond the 7-Year Mark: Navigating the Next Phase of Your Career

There is a paucity of specialty-specific guidance on leadership or how to advance within societies or specialty-specific organizations. Many of us aspire to hold positions in skull base leadership locally or nationally. This session leverages the experience of seasoned leaders in Skull Base Surgery to provide the audience with guidance about important aspects of leadership and engagement specific to our field.

At the conclusion of this session, attendees will be able to…

• Know how to get involved.
• Recommend how to excel and rise through the ranks.
• Contribute and leave a legacy.

8:35 AM: Career Building – Skull Base Leadership: Tips and Pearls

There is a paucity of specialty-specific guidance on leadership or how to advance within societies or specialty-specific organizations. Many of us aspire to hold positions in skull base leadership locally or nationally. This session leverages the experience of seasoned leaders in Skull Base Surgery to provide the audience with guidance about important aspects of leadership and engagement specific to our field.

At the conclusion of this session, attendees will be able to…

• Know how to get involved.
• Recommend how to excel and rise through the ranks.
• Contribute and leave a legacy.

1:20 PM: CSF Management – Controversies in Skull Base Reconstruction

This session will engage debate on controversial scenarios in skull base reconstruction. One of the panelists presents a given controversial skull base reconstruction case and a second panelist will debate about points of consideration, reconstructive strategies, and perioperative/postoperative management. The two panelists will be of different training backgrounds, specialties, and geographic practice locations. The session is suited for otolaryngologists, neurosurgeons, and ophthalmologists.

At the conclusion of this session, attendees will be able to…

• Understand nuances and challenges in specific skull base reconstruction cases.
• Compare different techniques for management of controversial scenarios in skull base reconstruction.
• Develop a framework for managing complex skull base reconstruction.

2:25 PM: CSF Management – Tricky Traumatic CSF Leaks

This session will provide an overview of strategies and updates for management of traumatic CSF leaks. Traumatic anterior skull base leaks are commonly seen in practice and had traditionally been repaired with craniotomy and pericranial grafts are now often repaired endoscopically, but many developments have been made recently. The session is suited for otolaryngologists, neurosurgeons, and ophthalmologists.

At the conclusion of this session, attendees will be able to…

• Understand the scope of traumatic CSF leaks from simple to complex.
• Develop a management strategy for traumatic CSF leaks of different calibers.
• Understand nuances related to sinus function and cosmesis related to traumatic CSF leaks.

4:00 PM: CSF Management – Idiopathic Intracranial Hypertension

This session will provide an overview of strategies and updates for management of traumatic CSF leaks. Traumatic anterior skull base leaks are commonly seen in practice and had traditionally been repaired with craniotomy and pericranial grafts are now often repaired endoscopically, but many developments have been made recently. The session is suited for otolaryngologists, neurosurgeons, and ophthalmologists.

• Identify diagnostic criteria and signs and symptoms suggestive of idiopathic intracranial hypertension.
• Understand treatment paradigms for idiopathic intracranial hypertension, both related to active CSF leak and not.
• Understand the multidisciplinary nature of this condition.

5:05 PM: CSF Management – CSF Leak Potpourri

This session covers core topics in CSF leaks that are of broad interest to the NASBS membership. The session is suited for otolaryngologists, neurosurgeons, and ophthalmologists.

At the conclusion of this session, attendees will be able to…

• Identify key etiologies for development of CSF leak.
• Understand state-of-the-art diagnosis of CSF leaks.
• Understand treatment strategies, both medical and surgical, for CSF leaks.

5:05 PM: AI/Technology – Applying Technological Advances to Skull Base Surgery

This session examines the state of the art and the next generation of augmented reality (AR) and virtual reality (VR) in skull base surgery. It is intended for surgeons who use navigation with or without AR/VR and want to keep up with the state of the art.

At the conclusion of this session, attendees will be able to…

• Understand the current and future applications of augmented reality (AR) and virtual reality (VR) in skull base surgery.
• Evaluate the potential benefits and risks of using AR and VR in skull base surgery.

5:05 PM: Pediatrics – Considerations in the Management of Pediatric Patients with Sellar and Parasellar Pathologies

This session will highlight and expand upon considerations and strategies relevant to managing skull base pathologies in young children.

At the conclusion of this session, attendees will be able to…

• Distinguish chordoma affecting children and the management of these from those affecting adult patients.
• Recommend strategies for managing endocrinologic alterations in children with skull base pathologies.
• Illustrate the intricacies affecting management decisions in craniopharyngioma in young children.

4:00 PM: Session 1: Orbit

The orbit is both a target and a route to the skull base depending on the pathology to treat. In this session we will review the surgical anatomy of the optic canal and orbit. We will discuss the indications and limits of the orbital approaches from the endonasal and transorbital routes. Attendance is recommended for all trainees and skull base specialists with an interest in treating pathology located in the orbit and transorbital approaches to the skull base.

7:30 AM Proffered Papers 19 – Training / Education 1
7:30 AM Proffered Video – Aneurysm / Vascular
8:35 AM Proffered Papers 21 – Training / Education 2
8:35 AM Proffered Video – Bypass
1:20 PM Proffered Papers 23 – Olfactory Neuroblastoma
1:20 PM Proffered Video- Chordoma / Chondrosarcoma
2:25 PM Proffered Papers 25 – Prolactinoma
2:25 PM Proffered Video – Combined Approaches
4:00 PM Proffered Papers 28 – Schwannomas & Lateral SB
4:00 PM Proffered Video – Craniocervical Junction
5:05 PM Proffered Papers 29 – Other 2
5:05 PM Proffered Video – Microsurgical Techniques

7:30 AM: Surgery in the Orbit

This session is designed for ophthalmologists, otolaryngologists and neurosurgeons who are interested in the treatment of orbital and adjacent pathology affecting the sinuses, skull base and brain.

At the conclusion of this session, attendees will be able to…

• Diagnose and treat primary orbit pathology.
• Identify diseases that affect the orbit secondarily (sinus, intracranial).
• Recognize disease for which the orbit can serve as a surgical corridor.

8:35 AM: Endoscopic Transorbital Surgery: Sinuses and Skull Base

This session will focus on the orbit as a portal to treat pathology of the adjacent sinuses and skull base. Ophthalmologists, otolaryngologists and neurosurgeons who are interested in the treatment of orbital and adjacent pathology affecting the sinuses, skull base will find these talks of interest.

At the conclusion of this session, attendees will be able to…

• Describe pathology that primarily and secondarily affects the paranasal sinuses.
• Plan an appropriate surgical approach that includes the orbit for paranasal sinus.
• Prioritize surgical goals for diseases that affect the sinuses, orbits and skull base.

1:20 PM: Transorbital Endoscopic Neurosurgery Part 1: Introduction

This session will discuss endoscopic brain surgery using the orbit as a portal. This will describe the surgical techniques as well as location and characteristics of (mostly) anterior fossa pathology that can be treated in this fashion. Ophthalmologists, otolaryngologists and neurosurgeons who are interested in the treatment of orbital and adjacent pathology of the skull base will find these talks of interest.

• Understand anatomy, techniques and indications for endoscopic transorbital neurosurgery.
• Plan an appropriate surgical approach that traverses the orbit.
• Prioritize endoscopic transorbital surgical goals for diseases that affect the anterior and middle cranial fossae.

2:25 PM: Transorbital Endoscopic Neurosurgery Part 2: Advanced

This session will discuss endoscopic brain surgery using the orbit as a portal, including  in pediatric patients. This will describe the surgical techniques as well as location and characteristics of middle fossa pathology that can be treated in this fashion. Ophthalmologists, otolaryngologists and neurosurgeons who are interested in the treatment of orbital and adjacent pathology of the skull base will find these talks of interest.

• Recognize middle fossa/pathology that can be accessed via the orbit.
• Prioritize surgical goals for diseases that affect the middle fossa using the orbit as a surgical corridor.
• Plan an appropriate surgical approach that traverses the orbit for middle fossa disease with or without orbital involvement.

4:00 PM: Transorbital Endoscopic Surgery: Nuances and Controversies

This session will discuss nuances in transorbital endoscopic surgery such as choice of endonasal vs transorbital surgery, ophthalmologic considerations, and techniques for transorbital endoscopic clinoidectomy. A panel discussion will be provided to discuss controversies such as avoidance of complications, use of a lumbar drain, appropriate case selection, and audience questions.

At the conclusion of this session, attendees will be able to…

• Recognize ophthalmologic issues in endoscopic transorbital.
• Understand considerations of transorbital vs transnasal skull base approaches.
• Implement transorbital techniques in anterior clinoidectomy.
• Formulate a transorbital surgical plan for advanced anterior/middle fossa disease.

8:35 AM: Open Skull Base & Cerebrovascular: The Inseparable Twins

This is a session on skull base and cerebrovascular indications, techniques, and training. Those who are interested in the treatment of cerebrovascular conditions such as aneurysms, AVM, or arterial reconstruction should attend.  Additionally, those interested in managing both arterial and venous injury during skull base surgery should attend.

At the conclusion of this session, attendees will be able to…

• Describe current techniques in arterial injury repair and reconstruction.
• Describe current techniques in venous injury repair and reconstruction.
• Distinguish ways in which cerebrovascular surgery and skull base surgery complement each other.

1:20 PM: My Worst Vascular Complications in Skull Base

This session will focus on the diagnosis and management of vascular complications such as arterial injury or venous injury during skull base surgery.

At the conclusion of this session, attendees will be able to…

• Describe current techniques in arterial injury repair and reconstruction.
• Describe current techniques in venous injury repair and reconstruction.
• Discuss new methods in training and modeling in vascular injury.

2:25: PM: Controversial Topics in Skull Base and Open Cerebrovascular

This is a session discussing new and controversial topics in cerebrovascular. Specifically discussing pathologies that are amenable to both open microsurgery and endovascular therapy.

At the conclusion of this session, attendees will be able to…

• Describe current techniques in arterial injury repair and reconstruction.
• Describe current techniques in venous injury repair and reconstruction.
• Discuss new methods in training and modeling in vascular injury.

4:00 PM: The Role of Skull Base in Traumatic Injuries: An Underutilized Skill?

This session is geared towards those interested in endoscopic surgery in the setting of trauma both for neural decompression and reconstruction.

At the conclusion of this session, attendees will be able to…

• Describe current techniques in arterial injury repair and reconstruction.
• Describe current techniques in venous injury repair and reconstruction.
• Discuss new methods in training and modeling in vascular injury.

5:00 PM: The Role of Skull Base Expertise in Neurovascular Compression Syndromes

This session is geared towards those interested in endoscopic surgery in the setting of trauma both for neural decompression and reconstruction.

At the conclusion of this session, attendees will be able to…

• Describe current management of common neural compression syndromes and the role of skull base and microsurgery.
• Discuss advanced techniques and methods for recurrent neural compression syndromes.
• Discuss the management of dolichoectasia in neural compression syndromes.

7:30 AM: Cholesterol Granuloma Cage Match: Can We Settle This Once And For All?

Case-based discussion focused on the management of petrous apex cholesterol granuloma. The session will discuss complication avoidance and optimal treatment planning.

At the conclusion of this session, attendees will be able to…

• Interpret imaging characteristics of cholesterol granulomas.
• Develop treatment algorithms for cholesterol granulomas.
• Appropriately manage cholesterol granulomas.

8:35 AM: Avoiding and Managing Surgical Complications During Petrosectomy

This session will focus on the techniques and tools to safely approach the petrous apex and avoid (or manage) complications.

At the conclusion of this session, attendees will be able to…

• Interpret imaging characteristics of pathology requiring petrosectomy.
• Develop treatment algorithms for pathology requiring petrosectomy.
• Appropriately manage pathology requiring petrosectomy.

1:20 PM: Tricky CSF Leaks of the MF/Petrous Apex

Didactic and case-based session focused on challenging middle fossa leaks, including multiple leaks, petrous apex leaks, encephaloceles at Meckels` cave, and tegmen with posterior fossa combo leaks.

At the conclusion of this session, attendees will be able to…

• Interpret imaging characteristics of petrous apex CSF leaks.
• Develop treatment algorithms for CSF leaks.
• Appropriately manage petrous apex CSF leaks.

2:25 PM: Controversies in Surgical Management of Superior Semicircular Canal Dehiscence Syndrome

This session will discuss transmastoid versus mcf, intraoperative monitoring, materials, role of IH or migraines in recovery and patient selection.

At the conclusion of this session, attendees will be able to…

• Interpret imaging characteristics of SCC dehiscence.
• Develop treatment algorithms for SCC dehiscence.
• Appropriately manage SCC dehiscence.

4:00 PM: Management of Endolymphatic Sac Tumors: Strategies for an Enduring Adversary

In this case-based session, we will discuss different approaches. include revision cases, syndromic testing, cases with varying degrees of cranial neuropathies, and adjuvant radiation.

At the conclusion of this session, attendees will be able to…

• Interpret imaging characteristics of Endolymphatic Sac Tumors.
• Develop treatment algorithms for Endolymphatic Sac Tumors.
• Appropriately manage Endolymphatic Sac Tumors.

5:05 PM: Evaluation and Management of Intralabyrinthine Schwannomas

Case-based discussion of imaging and treatment strategies for intralabyrinthine and intracochlear schwannomas with an emphasis on hearing and vestibular outcomes.  This session is aimed at neuro-otologists, neurosurgeons, radiation oncologists, and neuroradiologists.

At the conclusion of this session, attendees will be able to…

• Recognize imaging modalities for diagnosis of intralabyrinthine and intracochlear schwannomas.
• Discuss the natural history of intralabyrinthine and intracochlear schwannomas with regard to hearing and vestibular function.
• Understand the managing strategy for hearing loss and vestibular dysfunction in patients with intralabyrinthine and intracochlear schwannomas.

7:30 AM: The Great Debate: Management of Pituitary Apoplexy – What is the Evidence?

We will discuss evidence-based management for pituitary apoplexy including when surgery is needed and timing of surgery. What is the natural history vs. surgical impact – visual, endocrine, and oncologic outcomes?

At the conclusion of this session, attendees will be able to…

• Recognize when pituitary apoplexy requires urgent surgical intervention.
• Understand the impact of surgery on outcomes following pituitary apoplexy.
• Assess the current evidence regarding pituitary apoplexy.

8:35 AM: Endoscopic Approaches to Benign Sellar Pathology – How Much is Enough?

Moderators will present challenging cases of benign sellar pathologies and ask a panel of experts to discuss management and surgical considerations.

At the conclusion of this session, attendees will be able to…

• Compare minimal vs more standard approaches to the sella in terms of surgical success, patient healing, quality of life (sinonasal).
• Recommend a given approach for specific pathologies.
• Develop a greater understanding of the differences in these approaches.

1:20 PM: Sellar Lesions in the Fertile Female

We will discuss the effects of sellar surgery on fertility and the management of pituitary tumors in the pregnant population. Additionally we will discuss when tumors should be resected prior to planned pregnancy.

At the conclusion of this session, attendees will be able to…

• Understand the effects of pituitary surgery on fertility.
• Assess when surgery should be performed prior to planned pregnancy.
• Recommend appropriate management of pituitary tumors in pregnant patients.

2:25 PM: Giant Pituitary Adenomas – When to Attack from Above, Below, or Both?

Giant pituitary adenomas can be challenging lesions and the ideal surgical approach may not be clear. This session will discuss the type of approach – from below vs above, and when combined approaches are needed as well as reconstruction for combined approaches.

At the conclusion of this session, attendees will be able to…

• Compare surgical approaches for giant pituitary adenomas.
• Recognize when combined approaches are needed.
• Identify appropriate reconstruction strategies for surgeries where combined approaches are used.

4:00 PM: Complication Management in Benign Sellar Pathology – Peeing, Leaking, and When to Leave the Hospital

Sellar surgery is associated with specific complications – endocrine, infectious, vascular, and cerebrospinal fluid leak being some of the more common. We will discuss strategies for intra and post op management and prevention of complications, including minimizing impact on cost / length of stay when they happen using data-driven case-based discussion.

At the conclusion of this session, attendees will be able to…

• Identify intraoperative and postoperative strategies to decrease the risk of complications.
• Implement strategies to decrease complications and minimize effect on LOS and cost.
• Compare different reconstruction options for prevention of CSF leak.

7:30 AM: Value-based Care – Prehab, Enhanced Recovery After Surgery (ERAS) and Opioid Reduction in Skull Base Surgery

Prolonged hospital stay and increased postoperative morbidity following major surgery is a concern for all skull base teams. Enhanced recovery after surgery (ERAS) is a protocolized scientific pathway applied to boost the outcome and enhance the recovery phase after surgery and the theory and evidence for implementation of ERAS protocols in various types of skull base surgery will be discussed.

At the conclusion of this session, attendees will be able to…

• Integrate an Enhanced Recovery After Surgery (ERAS) protocol for skull base surgery.
• Employ an opioid-sparing analgesia regimen after surgery.
• Assess the value of pre-habilitation in skull base surgery.

5:05 PM: Pediatrics – The Pediatric Orbit

This is a case-based discussion of pediatric orbital cases highlighting key considerations in this population. Cases to be presented in 7-8 minutes with 2-3 minutes for discussion. Cases to include: tumors, inflammatory and infectious pathologies. Attendees: those who care for pediatric patients with orbital pathologies.

At the conclusion of this session, attendees will be able to…

• Recognize key considerations in managing pediatric orbital pathology.
• Evaluate and diagnose pediatric orbital pathology.
• Formulate and employ a team-based approach to managing patients with orbital pathologies.

7:30 AM: Session 2: Suprasellar, Paraclinoidal, Cavernous Sinus, Meckel’s Cave

In this session we will review the surgical anatomy of the paraclinoidal and suprasellar space, cavernous sinus and we will discuss the pros and cons of endonasal and transcranial approaches to these regions. Attendance is recommended for all trainees and skull base specialties with an interest in treating pathology located in the suprasellar and paraclinoidal regions.

4:00 PM: Session 3: Temporal Bone and Petroclival Region

In this session we will review the 3D surgical anatomy of the petroclival region, and we will discuss the pros and cons of endonasal and transcranial approaches to this complex area. Attendance is recommended for all trainees and faculty with an interest in managing pathology in this location.

7:30 AM Proffered Papers 31 – Meningioma 1
7:30 AM Proffered Papers 32 – Clivus / CVJ
7:30 AM Proffered Video – Pediatric / Anterior Skull Base
8:35 AM Proffered Papers 34 – Meningioma 2
8:35 AM Proffered Papers 35 – Anterior Skull Base 2
8:35 AM Proffered Video – Schwannoma
1:20 PM Proffered Papers 37 – Petroclival
1:20 PM Proffered Papers 38 – Best Papers
1:20 PM Proffered Video- Transpterygoid / Petrous Apex
2:25 PM Proffered Papers 40 – Meningioma 3
2:25 PM Proffered Papers 41 – CPA / Jugular Foramen
2:25 PM Proffered Video – Best Videos
4:00 PM Proffered Papers 43 – Vestibular Schwannoma 1
4:00 PM Proffered Papers 44 – Pediatrics
4:00 PM Proffered Video- Vascular Lesions
5:05 PM Proffered Papers 46 – Vestibular Schwannoma 2
5:05 PM Proffered Papers 47 – Reconstruction / CSF Leak
5:05 PM Proffered Video – Miscellaneous

7:30 AM: NASAOS Presents: Perioperative Considerations for Skull Base Orbital Surgery

This session will focus on the many considerations for skullbase orbital surgery.

• Understand the options for orbital approaches.
• Understand how to handle complications.
• Approach care from a multidisciplinary angle.

7:30 AM: Skull Base Survivorship and Patient Reported Outcomes

Skull base cancer survivors have unique needs and symptom burden. This session aims to equip clinicians with the information to develop a survivorship care pathway for patients with these rare tumors, from understanding best practices, to utilizing patient reported outcomes.

At the conclusion of this session, attendees will be able to…

• Describe the various facets of survivorship care and best practices for developing a survivorship program.
• Understand the impact of multi-modality therapy on function and symptom burden in skull base tumor survivors.
• Understand the pros, cons and utility of various skull base patient reported outcome instruments.
• Describe current application of PROs in cancer care (ie, patient care, therapeutic development, research) and future directions.

8:35 AM: Managing Head and Neck Treatment Toxicity After Multimodality Therapy for Skull Base Tumors

This session aims to describe the head and neck morbidity of surgery and multimodality therapy for skull base tumors, as well as their management. Topics covered include hearing, balance, nasal cavity, olfaction, dental, neck morbidity and lower cranial nerves.

At the conclusion of this session, attendees will be able to…

• Describe the incidence and mechanism of vestibular and auditory dysfunction after surgery and multimodality therapy to anterior and central skull base, as well as an overview of management options (including hearing, balance, ETD, ME/mastoid issues).
• Discuss the nasal morbidity of skull base surgery and multimodality therapy, and strategies to minimize morbidity through surgical modification and medical management.
• Describe the impact of skull base surgery and multimodality therapy on olfaction, as well as evidence-based approaches for prevention and rehabilitation.
• Discuss dental, trismus and neck morbidity (ie, neck spasm, lymphoedema, etc) after surgery and multimodality therapy, and potential therapeutic options.
• Discuss contemporary management strategies for lower cranial nerve dysfunction and late effects.

10:05 AM: Managing Neurocognitive and Ophthalmic Sequelae of Skull Base Multimodality Therapy

This session aims to describe the neurocognitive and ophthalmic sequelae of surgery and multimodality management for skull base tumors. We will discuss patterns of neurocognitive decline related to chemotherapy, systemic therapy, radiotherapy and surgery,  diagnosis and treatment. We will highlight the impact of surgery, radiotherapy, and systemic therapy on the orbit, as well as an overview of treatment options.

At the conclusion of this session, attendees will be able to…

• Describe the effects of tumor and treatment on the CNS, their incidence, diagnosis and assessment, with a focus on skull base tumors.
• Discuss treatment options for tumor and therapy related neurocognitive decline.
• Describe the psycho-social impact of cancer and evidence based interventions, with a focus on brain and head and neck tumors.
• Discuss orbital impairments related to skull base tumor and surgery, and their treatment (i.e.. corneal re-innervation, enophthalmos, diplopia).
• Understand drug and radiotherapy related orbital toxicity, their management options and when to refer.

11:10 AM: Dental and Maxillofacial Rehabilitation

Management of head and neck cancer imparts significant treatment morbidity. Oral and facial rehabilitation has the potential to significantly improve quality of life in this patient population. This session will focus on the impact of rehabilitation and the most contemporary thoughts on oral and CMF rehabilitation for this patient population.

At the conclusion of this session, attendees will be able to…

• Describe the impact of head and neck care on QoL and the impact that different elements of oral rehabilitation has on QoL.
• Update on best practices for pretherapy dental care/clearance and management during and after therapy to include dry mouth, trismus and tooth replacement.
• Provide an overview of immediate bony reconstruction with immediate dental implant and prosthetic placement and its indications in the head and neck cancer patient.
• Describe the best practices in oral rehabilitation in the head and neck patient population and review when immediate dental implants would not be indicated.
• Understand TMJ replacement after ablative surgery can be accomplished with autogenous and alloplastic means with each having distinctive advantages and disadvantages that will be explored in this session.

7:30 AM: New Developments for Hearing Preservation and Rehabilitation in Vestibular Schwannomas and Skull-Based Tumors

Session aimed at the general audience exploring the role of hearing aids, bone auditory implants, cochlear implants, and ABI for hearing rehabilitation with discussion of case selection.

At the conclusion of this session, attendees will be able to…

• Assess the treatment options for hearing rehabilitation in patients with skull base tumors, including vestibular schwannomas.
• Recognize patient selection criteria for cochlear implant and auditory brainstem implant in hearing-impaired patients with skull base tumors.

8:35 AM: Management of Vertigo and Dysequilibrium in Patients with Skull-Based Tumors

Case-based discussion focused on the assessment of dysequilibrium in patients with skull-base tumors, including vestibular schwannoma.  The session will discuss the tools for evaluating self-reported and objective vestibular dysfunction, the impact of dysequilibrium on quality-of-life before and after treatment, and compare treatment modalities for persistent dysequilibrium.

At the conclusion of this session, attendees will be able to…

• Recognize the impact of vestibular deficit on QOL of patients with skull-base tumors.
• Evaluate the tools for self-reported dysequilibrium handicap and the tests of vestibular function to identify patients at risk for prolonged disability.
• Compare the indications and outcome for treatment modalities for dysequilibrium including intratympanic gentamicin, vestibular neurectomy, and vestibular rehabilitation.

10:05 AM: Debate Session: Management of Vestibular Schwannomas in Patients with Preserved Hearing

Debate session with experts in the field discussing the advantages and disadvantages of the different treatment strategies for patients with vestibular schwannomas and preserved hearing. The panelists will provide a brief overview of hearing outcomes for the strategies followed by an interactive case-based discussion. Neuro-otologists, radiation oncologists, neurosurgeons, and audiologists should attend.

At the conclusion of this session, attendees will be able to…

• Compare hearing preservation outcomes with different treatment strategies for vestibular schwannoma.
• Differentiate the advantages and disadvantages of treatment strategies for vestibular schwannomas in patients with preserved hearing.

7:30 AM: Challenges in Diagnosis and Management of Cushing Disease

This session will discuss diagnostic and therapeutic challenges in Cushing`s Disease. Attendees will include neurosurgeons, endocrinologists, ENTs, pathologists, and Neuro-oncologists.

At the conclusion of this session, attendees will be able to…

• Identify the clinical and biochemical approach to distinguish non neoplastic and neoplastic hypercortisolism.
• Articulate the technical pitfalls of IPSS, convey the utility of a prolactin-adjusted IPS: PRL ratio and illustrate anatomical variations in pituitary drainage that can affect the IPSS interpretation.
• Discuss the different strategies and technical aspects of surgical gland exploration in MRI negative CD.
• Compare the steroid vs non steroid sparing protocols for early post-operative assessment, prophylactic antithrombotic measures in Cushing Disease and management of cortisol withdrawal syndrome.
• Illustrate with cases the challenges of diagnosing Cushing`s disease, achieving surgical remission and unusual differential diagnosis for Cushing`s disease.

8:35 AM: Updates in Growth Hormone and Prolactin Secreting PitNET

This session will discuss recent advances in medical therapy, personalized medicine, the role of surgery, challenging cases, and the recognition of comorbidities associated with Acromegaly and Prolactinomas. Attendees: neurosurgeons, endocrinologists, radiologists, ENTs, pathologists, and neuro-oncologists.

At the conclusion of this session, attendees will be able to…

• Identify indications for medical therapy, discuss the latest trials on medical therapy and compare main side effects of different medical therapy for Somatotroph PitNET.
• Illustrate the personalized medical treatment for patients with Acromegaly.
• Diagnose approach for most common comorbidities associated with Acromegaly.
• Recognize surgical indications for prolactinomas.
• Illustrate with cases the challenges of perioperative management, and timing of assessing and treating residual and/or recurrent disease.

10:05 AM: M&M in Functioning PitNET

This session will discuss complications associated with . different treatment modalities in the management of functioning PitNET. Attendees will include neurosurgeons, endocrinologists, ENTs, pathologists, and neuro-oncologists.

At the conclusion of this session, attendees will be able to…

• Evaluate preoperatively patients at higher risk for sinonasal and reconstruction postoperative surgical complications.
• Recognize the risk of SIADH after surgery and discuss preventive measures to decrease the risk of hyponatremia.
• Evaluate preoperatively patients at higher risk for intraoperative and immediate postoperative surgical complications.

11:10 AM: Innovations in Functioning PitNET

The session will discuss recent advances in imaging studies and novel imaging techniques for evaluating the pituitary gland, updates in radiosurgery for PitNET, and post-operative surveillance after surgical remission in patients with Acromegaly and Cushing Disease. Attendees will include neurosurgeons, endocrinologists, ENTs, radiologists, pathologists, and neuro-oncologists.

At the conclusion of this session, attendees will be able to…

• Demonstrate the utility of functional and molecular imaging.
• Demonstrate the utility of current intraoperative adjuncts to maximize surgical resection.
• Recognize pathology and molecular markers of poor prognosis in PitNET.
• Convey future perspectives in precision medicine for aggressive PitNET.
• Select patients who are appropriate for radiation therapy treatment modality.

7:30 AM: Reconstruction and Radiotherapy: Functional and Growth Considerations in Kids

This session will cover key points to consider when managing children with skull base pathologies who undergo reconstructive surgery and/or radiation.

At the conclusion of this session, attendees will be able to…

• Manage treatment effects of radiation in children.
• Identify issues in craniofacial growth and development when considering surgical approaches.
• Recognize the differences in skull base reconstruction in children vs adults.

8:35 AM: Rare Skull Base Tumors in Children

Through a panel of presenters, this session will introduce rare instances of skull base tumors occurring in children and discuss management strategies from diagnosis to treatment.

At the conclusion of this session, attendees will be able to…

• Articulate diagnostic and interventional considerations when addressing relatively rare clinical scenarios in children.
• Integrate the experience of colleagues in the care of children with rarer skull base tumors.
• Employ strategies gleaned from colleagues in the care of children with rarer skull base tumors.

10:05 AM: Pediatric NF2: Fighting a Noble Battle

Discussion of neurofibromatosis and vestibular schwannoma management in children: Medical management, surgery vs radiosurgery, Managing hearing, swallowing and expectations, etc. We will also review contemporary diagnosis in pediatric skull base tumors: NF2 and beyond (what should we be doing to evaluate kids with skull base tumors to rule out genetic susceptibility syndromes). Attendees: anyone who treats NF2 in children.

At the conclusion of this session, attendees will be able to…

• Employ current strategies, both medical and surgical, in managing NF2 in children.
• Recognize ways to manage outcomes (hearing, swallowing, etc.) in pediatric NF2 patients.
• Identify current methods of diagnosing NF2.

11:10 AM: Neurovascular Considerations in Children

In conjunction with the anterior skull base track, this session will explore the intersection between the management of anterior skull base pathologies most commonly seen in children with cerebrovascular considerations.

At the conclusion of this session, attendees will be able to…

• Identify cerebrovascular considerations relevant to pediatric skull base pathologies, including trauma.
• Recognize testing and planning needed to optimize outcomes where cerebrovascular considerations may affect the management of pediatric skull base pathologies.
• Illustrate scenarios where cerebrovascular conditions may affect the management of pediatric skull base pathologies.

7:30 AM: Session 4 Dueling Dissections: Lower Clivus and Foramen Magnum

In this session we will review the 3D surgical anatomy of the Lower Clivus and Foramen Magnum regions, and we will discuss the pros and cons of endonasal and transcranial approaches to these regions. Attendance is recommended for all trainees and faculty with an interest in managing pathology in these locations.

• Develop a better understanding of the surgical anatomy of the Lower Clivus and Foramen Magnum.
• Recognize key surgical landmarks and technical nuances for the endonasal and transcranial approach to the Lower Clivus and Foramen Magnum.
• Compare the benefits and disadvantages of endonasal and transcranial approaches to the Lower Clivus and Foramen Magnum.

7:30 AM Proffered Papers 49 – Orbit
7:30 AM Proffered Video 49 – Pituitary Adenoma
8:35 AM Proffered Papers 51 – Technique / Technology 1
8:35 AM Proffered Papers 52 – Head & Neck Tumors
8:35 AM Proffered Video- Sellar / Suprasellar
10:05 AM Proffered Papers 54 – Technique / Technology 2
10:05 AM Proffered Papers 55 – Anatomy
10:05 AM Proffered Papers 56 – Vascular 1
11:10 AM Proffered Papers 57 – Value-Based Care / Quality of Life
11:10 AM Proffered Papers 58 – Cavernous Sinus / Middle Fossa
11:10 AM Proffered Papers 59 – Vascular 2
11:10 AM Proffered Papers 60 – Miscellaneous 2