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Multi-Institutional Modified Delphi For Genomics in Expert Consensus Survey of Genomic Testing for Anterior Skull
Anirudh Saraswathula1, Shreya Sriram1, Corinna Levine2
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
Journal of Neurological Surgery. Part B, Skull Base
|January 8, 2026
Summary
Genomic testing for anterior skull base malignancies is increasingly used without clear guidelines. Expert consensus now recommends its use for recurrent, metastatic, or unresectable rare tumors.
Area of Science:
- Oncology
- Genomics
- Surgical Pathology
Background:
- Genomic testing is increasingly utilized for anterior skull base malignancies.
- Current literature is limited, necessitating expert consensus on testing indications.
- High-volume North American cranial base surgical programs participated in this study.
Purpose of the Study:
- To establish expert consensus on the indications for genomic testing in anterior skull base malignancies.
- To address the lack of clear guidelines in this evolving field.
Main Methods:
- A modified Delphi expert consensus process was employed.
- Thirteen high-volume North American cranial base surgical centers participated.
- Institutional representatives (otolaryngologists) responded to Delphi surveys to determine consensus.
Main Results:
- Genomic testing is available at most participating institutions.
- Consensus was reached on 22 of 38 statements.
- Key areas of agreement included testing for rare tumors with recurrence, distant metastasis, or unresectable status, and those with a family history.
Conclusions:
- Expert consensus supports genomic sequencing for specific scenarios in anterior skull base malignancies, including recurrence, metastasis, and unresectable tumors.
- Further research is required to fully define the role of genomic sequencing in managing these rare conditions.
