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In World neurosurgery ; h5-index 47.0

This article broadly outlines the potential advances in the field of skull base surgery, which may occur in the next 20 years based on many areas of current research in biology and technology. Many of these advances are also broadly applicable to other areas of neurosurgery. We ground our predictions for future developments in an exploration of what patients and surgeons most desire as outcomes for care. This leads to an examination of recent developments in the field and outlines several promising areas of future improvement in skull base surgery, per se, as well as identifying new hospital support systems needed to accommodate these changes. These include, but are not limited to advances in imaging, Raman Spectroscopy and Microscopy, 3-dimensional printing and rapid prototyping, master-slave and semi-autonomous robots, artificial intelligence applications in all areas of medicine, tele-medicine, and green technologies in hospitals. In addition, we review therapeutic approaches employing nanotechnology, genetic engineering and anti-tumoral antibodies, as well as stem cell technologies to repair damage caused by traumatic injuries, tumors, and iatrogenic injuries to the brain and cranial nerves. Additionally, we discuss the training requirements for future skull- base surgeons and stress the need for adaptability and change. However, the essential requirements for skull base surgeons remain unchanged, namely: knowledge, attention to details, technical skill, innovation, judgement, and compassion. Our conclusion is that active involvement in these rapidly evolving technologies will enable us to shape some of the future of our discipline to address the needs of both patients and our profession.

Sekhar Laligam N, Juric-Sekhar Gordana, Qazi Zeeshan, Patel Anoop, McGrath Lynn B, Pridgeon James, Kalavakonda Niveditha, Hannaford Blake