Nolan Brown, Zach Pennington, Saarang Patel, Cathleen C. Kuo, Sachiv Chakravarti, Nicholas E. Bui, Julian Gendreau, Jamie J Van Gompel
{"title":"嗅沟脑膜瘤切除手术方法:鼻内镜与经颅、单侧与双侧手术方法的比较分析","authors":"Nolan Brown, Zach Pennington, Saarang Patel, Cathleen C. Kuo, Sachiv Chakravarti, Nicholas E. Bui, Julian Gendreau, Jamie J Van Gompel","doi":"10.1055/a-2297-9055","DOIUrl":null,"url":null,"abstract":"Here we systematically review the extant literature to highlight the advantages of bilateral versus unilateral approaches and endoscopic endonasal (midline) approaches versus transcranial approaches for olfactory groove meningiomas, focusing on complications, extent of resection, and local recurrence rates.\nMethods\nThree databases were queried to identify all primary prospective trials and retrospective series comparing outcomes following endoscopic endonasal versus transcranial approaches and unilateral versus bilateral craniotomy for surgical resection of olfactory groove meningiomas. All articles were screened by two independent authors and selected for formal analysis according to predefined inclusion/exclusion criteria.\nResults:\nSeven studies comprising 288 total patients (mean age 55.0 ± 24.6 years) met criteria for inclusion. In the three comparing the endoscopic endonasal (n=21) versus transcranial (n=32) approaches, there was no significant difference between the two with respect to gross total resection (p=0.34) or rates of Simpson Grade 1 resection (p=0.69). EEA demonstrated higher rates of overall complications (p<0.01) including postoperative infection (p=0.03). In the four studies comparing bilateral (n=117) versus unilateral approaches (n=118), overall complication rates (p<0.01) and disease recurrence (p=0.01) were higher with bilateral approaches. All surgery-related mortalities also occurred in the bilateral cohort (n=7, 7.14%). Gross total resection (p=0.63) and Simpson grade (p=0.48) were comparable between approaches. Olfaction preservation was superior for unilateral approaches (p<0.01).\nConclusions\nThough the literature is limited, current evidence suggests that the EEA may be favorable over conventional craniotomy for select olfactory groove meningioma patients. Where craniotomy is used, unilateral approaches appear to reduce complications and the risk of olfaction loss","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surgical Approaches to Resection of Olfactory Groove Meningiomas: Comparative Meta-Analysis of the Endoscopic Endonasal versus Transcranial and Unilateral versus Bilateral Approaches\",\"authors\":\"Nolan Brown, Zach Pennington, Saarang Patel, Cathleen C. Kuo, Sachiv Chakravarti, Nicholas E. Bui, Julian Gendreau, Jamie J Van Gompel\",\"doi\":\"10.1055/a-2297-9055\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Here we systematically review the extant literature to highlight the advantages of bilateral versus unilateral approaches and endoscopic endonasal (midline) approaches versus transcranial approaches for olfactory groove meningiomas, focusing on complications, extent of resection, and local recurrence rates.\\nMethods\\nThree databases were queried to identify all primary prospective trials and retrospective series comparing outcomes following endoscopic endonasal versus transcranial approaches and unilateral versus bilateral craniotomy for surgical resection of olfactory groove meningiomas. All articles were screened by two independent authors and selected for formal analysis according to predefined inclusion/exclusion criteria.\\nResults:\\nSeven studies comprising 288 total patients (mean age 55.0 ± 24.6 years) met criteria for inclusion. In the three comparing the endoscopic endonasal (n=21) versus transcranial (n=32) approaches, there was no significant difference between the two with respect to gross total resection (p=0.34) or rates of Simpson Grade 1 resection (p=0.69). EEA demonstrated higher rates of overall complications (p<0.01) including postoperative infection (p=0.03). In the four studies comparing bilateral (n=117) versus unilateral approaches (n=118), overall complication rates (p<0.01) and disease recurrence (p=0.01) were higher with bilateral approaches. All surgery-related mortalities also occurred in the bilateral cohort (n=7, 7.14%). Gross total resection (p=0.63) and Simpson grade (p=0.48) were comparable between approaches. Olfaction preservation was superior for unilateral approaches (p<0.01).\\nConclusions\\nThough the literature is limited, current evidence suggests that the EEA may be favorable over conventional craniotomy for select olfactory groove meningioma patients. Where craniotomy is used, unilateral approaches appear to reduce complications and the risk of olfaction loss\",\"PeriodicalId\":16513,\"journal\":{\"name\":\"Journal of Neurological Surgery Part B: Skull Base\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-04-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neurological Surgery Part B: Skull Base\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2297-9055\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurological Surgery Part B: Skull Base","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2297-9055","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Surgical Approaches to Resection of Olfactory Groove Meningiomas: Comparative Meta-Analysis of the Endoscopic Endonasal versus Transcranial and Unilateral versus Bilateral Approaches
Here we systematically review the extant literature to highlight the advantages of bilateral versus unilateral approaches and endoscopic endonasal (midline) approaches versus transcranial approaches for olfactory groove meningiomas, focusing on complications, extent of resection, and local recurrence rates.
Methods
Three databases were queried to identify all primary prospective trials and retrospective series comparing outcomes following endoscopic endonasal versus transcranial approaches and unilateral versus bilateral craniotomy for surgical resection of olfactory groove meningiomas. All articles were screened by two independent authors and selected for formal analysis according to predefined inclusion/exclusion criteria.
Results:
Seven studies comprising 288 total patients (mean age 55.0 ± 24.6 years) met criteria for inclusion. In the three comparing the endoscopic endonasal (n=21) versus transcranial (n=32) approaches, there was no significant difference between the two with respect to gross total resection (p=0.34) or rates of Simpson Grade 1 resection (p=0.69). EEA demonstrated higher rates of overall complications (p<0.01) including postoperative infection (p=0.03). In the four studies comparing bilateral (n=117) versus unilateral approaches (n=118), overall complication rates (p<0.01) and disease recurrence (p=0.01) were higher with bilateral approaches. All surgery-related mortalities also occurred in the bilateral cohort (n=7, 7.14%). Gross total resection (p=0.63) and Simpson grade (p=0.48) were comparable between approaches. Olfaction preservation was superior for unilateral approaches (p<0.01).
Conclusions
Though the literature is limited, current evidence suggests that the EEA may be favorable over conventional craniotomy for select olfactory groove meningioma patients. Where craniotomy is used, unilateral approaches appear to reduce complications and the risk of olfaction loss
期刊介绍:
The Journal of Neurological Surgery Part B: Skull Base (JNLS B) is a major publication from the world''s leading publisher in neurosurgery. JNLS B currently serves as the official organ of several national and international neurosurgery and skull base societies.
JNLS B is a peer-reviewed journal publishing original research, review articles, and technical notes covering all aspects of neurological surgery. The focus of JNLS B includes microsurgery as well as the latest minimally invasive techniques, such as stereotactic-guided surgery, endoscopy, and endovascular procedures. JNLS B is devoted to the techniques and procedures of skull base surgery.