After analysis of all evaluated factors, only bilateral hematoma was found correlated with high recurrence rate (p = 0.01), probably due to previous brain atrophy or existing coagulopathy.
BACKGROUND
Stereotactic radiosurgery (SRS) is increasingly considered for selected olfactory groove meningiomas (OGMs).
OBJECTIVE
To investigate the safety and efficacy of SRS for OGMs.
METHODS
From 20 institutions participating in the International Radiosurgery Research Foundation, we pooled patients who underwent SRS for histologically confirmed or radiologically suspected WHO grade I OGMs and were followed for 6 mo or more after the SRS.
RESULTS
In total, 278 (median age 57 yr) patients underwent SRS for histologically confirmed (29%) or radiologically suspected (71%) WHO grade I OGMs Median treatment volume was 4.60 cm3 (range: 0.12-27.3 cm3), median prescription dose was 12 Gy, and median dose to the olfactory nerve was 11.20 Gy. During median post-SRS imaging follow-up of 39 mo (range: 6-240 mo), 43% of patients had partial or marginal response, 54% of patients had stable disease, and 3% of patients experienced progression. During median post-SRS clinical follow-up of 51 mo (range: 6-240 mo), 36 (13%) patients experienced clinical and/or radiological adverse radiation events (AREs). Elevated risk of AREs was associated with larger OGM volume (P = .009) and pre-SRS peritumoral T2/fluid-attenuated inversion-recovery signal abnormalities (P < .001). After the SRS, olfaction remained stable, improved, or deteriorated in 90%, 8%, and 2% of patients, respectively. Complete post-SRS anosmia was predicted by partial/complete anosmia before the SRS (odds ratio [OR] = 83.125; 95% CI [24.589-281.01], P < .001) and prior resection of OGM (OR = 3.919; 95% CI [1.713-8.970], P = .001).
CONCLUSION
SRS is associated with durable local control of the majority of OGM patients with acceptable safety profile. SRS allows preservation or improvement of olfactory function in the majority of OGM patients.
ÖzeT Yenidoğan yaş grubundaki acil spinal girişimlerin önemli bir kısmını meningomyelosel olguları oluşturmaktadır. Olgularda çoğu zaman ek malformasyonların varlığı, genel anestezi uygulamasını güçleştirmektedir. Hastanemiz kadın hastalıkları ve doğum kliniğinde doğurtulan ve BOS sızıntısının eşlik ettiği bir meningomyelosel olgusu için kesenin cerrahi olarak kapatılması planlandı. Genel anestezi uygulamasının yüksek risk taşıması ve kese boyut ve yerleşiminin spinal anestezi uygulamasına engel olması nedeniyle hasta sedoanaljezi altında opere edildi. Sedoanaljezi, genel ve spinal anestezi için elverişli olmayan olgularda alternatif bir yöntem olarak göz önüne alınabilir. Sedasyon derinliği ve yöntemi her hasta için özel olarak şekillendirilmelidir.
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