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- Title
Petroclival meningiomas: the risk of post-operative cranial nerve deficits among different surgical approaches—a systematic review and meta-analysis.
- Authors
Di Carlo, Davide Tiziano; Capo, Gabriele; Fava, Arianna; Cagnazzo, Federico; Margil-Sànchez, Miguel; Champagne, Pierre-Olivier; Voormolen, Eduard H. J.; Morganti, Riccardo; Froelich, Sébastien; Perrini, Paolo
- Abstract
Background: The surgical resection of petroclival meningiomas (PCMs) remains a challenge. Both the relationship with neurovascular structures and the deep location of the tumor can affect the extent of resection and the rate of post-operative morbidity. Methods: The authors performed a systematic review and meta-analysis of the literature examining the rate of new cranial nerve (CN) deficits after resection of PCM. A systematic search of two databases was performed for studies published between 1990 and 2018. Random-effect meta-analysis was used to pool the rate of post-operative CN deficits, mortality rate, and rate of radical resection. Results: We included twelve studies and 334 patients harboring PCM. The overall rate of complete resection was 68% (95% CI 57.9–78.2%; p < 0.01; I2 = 83%). The rate of early and late post-operative CN deficits was the following: 3.8 and 2.7% (III CN), 6.6 and 3% (IV), 7.3 and 5.5% (V CN), 8 and 3.6% (VI CN), 8.9 and 8.9%% (VIII), and 4 and 2.7% (IX-XI CNs) (I2 = 0%, and p < 0.01 for all analyses). The risk of post-operative deficit of the IV CN was higher among the petrosal group (7.6%; I2 = 0% vs 2.1%; I2 = 0%), whereas the impairment of VII CN function was higher among retrosigmoid group (16.6%; I2 = 64.6% vs 11.4%; I2 = 52.8%), but it was transient in the majority of cases. Conclusions: This systematic review and meta-analysis provides a detailed overview of post-operative CN deficits ensuing surgical resection of PCMs. These findings should be acknowledged when counseling patients with PCMs regarding the more appropriate approach for their tumor.
- Subjects
CRANIAL nerves; META-analysis; SURGICAL excision; DATABASE searching
- Publication
Acta Neurochirurgica, 2020, Vol 162, Issue 9, p2135
- ISSN
0001-6268
- Publication type
Article
- DOI
10.1007/s00701-020-04395-6