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The endoscope-assisted supraorbital 'keyhole' approach for anterior skull base meningiomas: an updated meta-analysis
- Publication Year :
- 2020
- Publisher :
- Springer Vienna, 2020.
-
Abstract
- Introduction: The gold-standard treatment for symptomatic anterior skull base meningiomas is surgical resection. The endoscope-assisted supraorbital “keyhole” approach (eSKA) is a promising technique for surgical resection of olfactory groove (OGM) and tuberculum sellae meningioma (TSM) but has yet to be compared with the microscopic transcranial (mTCA) and the expanded endoscopic endonasal approach (EEA) in the context of existing literature. Methods: An updated study-level meta-analysis on surgical outcomes and complications of OGM and TSM operated with the eSKA, mTCA, and EEA was conducted using random-effect models. Results: A total of 2285 articles were screened, yielding 96 studies (2191 TSM and 1510 OGM patients). In terms of effectiveness, gross total resection incidence was highest in mTCA (89.6% TSM, 91.1% OGM), followed by eSKA (85.2% TSM, 84.9% OGM) and EEA (83.9% TSM, 82.8% OGM). Additionally, the EEA group had the highest incidence of visual improvement (81.9% TSM, 54.6% OGM), followed by eSKA (65.9% TSM, 52.9% OGM) and mTCA (63.9% TSM, 45.7% OGM). However, in terms of safety, the EEA possessed the highest cerebrospinal fluid leak incidence (9.2% TSM, 14.5% OGM), compared with eSKA (2.1% TSM, 1.6% OGM) and mTCA (1.6% TSM, 6.5% OGM). Finally, mortality and intraoperative arterial injury were 1% or lower across all subgroups. Conclusions: In the context of diverse study populations, the eSKA appeared not to be associated with increased adverse outcomes when compared with mTCA and EEA and offered comparable effectiveness. Case-selection is paramount in establishing a role for the eSKA in anterior skull base tumours.
- Subjects :
- Male
Natural Orifice Endoscopic Surgery
Cerebrospinal Fluid Leak
Supraorbital keyhole
Tumor – Meningioma
Middle Aged
Vascular System Injuries
Eye
Skull Base Neoplasms
Original Article - Tumor - Meningioma
Postoperative Complications
Neuroendoscopy
Meningeal Neoplasms
Humans
Skull base surgery
Female
Endoscopic transsphenoidal surgery
Olfactory groove meningioma
Meningioma
Microscopic transcranial surgery
Tuberculum Sellae Meningioma
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....c5ad6ee12507eb8039eb2f7727c3b0fa