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Background Risk stratification based on standardized quality measures has become crucial in neurosurgery. Contemporary quality indicators have often been developed for a wide range of neurosurgical procedures collectively. The accuracy of tumor-inherent characteristics of patients diagnosed with meningioma remains questionable. The objective of this study was the analysis of currently applied quality indicators in meningioma surgery and the identification of potential new measures. Methods Data of 133 patients who were operated on due to intracranial meningiomas were subjected to a retrospective analysis. The primary outcomes of interest were classical quality indicators such as the 30-day readmission, 30-day reoperation, 30-day mortality, 30-day nosocomial infection, and the 30-day surgical site infection rate. Uni- and multivariate analyses were performed. The occurrence of a new postoperative neurologic deficit was analyzed as a potential new quality indicator. Results The overall unplanned readmission rate was 3.8%; 13 patients were reoperated within 30 days (9.8%). The 30-day nosocomial infection and surgical site infection rates were 6.8 and 1.5%, respectively. A postoperative new neurologic deficit or neurologic deterioration as a currently assessed quality feature was observed in 12 patients (9.2%). The edema volume on preoperative scans proved to have a significant impact on the occurrence of a new postoperative neurologic deficit (p = 0.023). Conclusions Classical quality indicators in neurosurgery have proved to correlate with considerable deterioration of the patient's health in meningioma surgery and thus should be taken into consideration for application in meningioma patients. The occurrence of a new postoperative neurologic deficit is common and procedure specific. Thus, this should be elucidated for application as a complementary quality indicator in meningioma surgery. [ABSTRACT FROM AUTHOR]

Background and Objectives: The jugular fossa (JF) is a challenging area for surgical approaches because of its complex anatomy and proximity to neurovascular structures. The study evaluates the feasibility of the neuronavigated microsurgical transmastoid extended infralabyrinthine extradural retrofacial approach (mTEIER-A) in human head specimens for accessing the entire intraosseous JF in relation to the position of the sigmoid sinus (SS), horizontal angle of attack, and size of the SS., Methods: The mTEIER-A was performed on human head specimens. Before dissection, the position of the SS, horizontal angle of attack, and size of the SS were measured on tilted axial high resolution computed tomography scans; after dissection, access to the lateral aspect of the JF on dissected human head specimens and on postoperative high-resolution computed tomography scans was examined. The position of the SS was classified relative to a predefined reference line, and the feasibility of retrofacial access was documented., Results: SS positions located medial to the reference line (P1) and horizontal angles >12.5° significantly enhance retrofacial access to the lateral aspect of the JF, whereas the size of the SS has a limited impact., Conclusion: Depending on the position of the SS and the horizontal angle of access, mTEIER-A provides sufficient retrofacial access to the lateral aspect of the JF. These findings emphasize the need for precise preoperative planning and suggest that mTEIER-A could minimize the need for more invasive approaches, potentially reducing related morbidity. Further clinical studies are recommended to validate these findings., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)