Comparison and evolution of transcranial versus endoscopic endonasal approaches for suprasellar Meningiomas: A systematic review

Jimenez, Adrian E.; Snyder, Howard M.; Rabinovich, Emily P; Malkawi, Dima; Chakravarti, Sachiv; Wei, Oren; Cheshire, Madeline; Price, Carrie; Khalafallah, Adham M.; Rowan, Nicholas R.; Mukherjee, Debraj

doi:10.1016/j.jocn.2022.03.029

Cited by 7 publications

(7 citation statements)

References 68 publications

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“…The results showed that there were no differences in the rate of gross total resection or perioperative complications between the two groups. In another meta-analysis by Jimenez et al ( 20 ), they also obtained the same result. In our case series, the GTR was 91.11 and 87.18% in the EEEA group and the craniotomy group, which was similar to previous literature.…”

Section: Discussionsupporting

confidence: 59%

“…Although a more excellent visual prognosis could be harvested in the endoscopic group, the extent of tumor resection seemed to be similar between the two groups based on the previous reports ( 5 , 6 , 11 , 16 , 20 ). Bander et al ( 17 ) reported that the average extent of resection achieved was not significantly different between the two groups (98.80% ± 3.32% vs. 95.13% ± 11.69%, p = 0.206).…”

Section: Discussionmentioning

confidence: 52%

“…In the past, cerebrospinal fluid (CSF) leakage was a common and serious complication after neuroendoscopic surgery, which could result in secondary tension pneumocephalus and meningitis and significantly limited the development of neuroendoscopic skill. Since a vascularized septal mucosal flap was applied to the skull base reconstruction, the prevalence of CSF leakage after endoscopic transnasal surgery has been reduced considerably ( 20 , 22 – 24 ). Yu et al ( 11 ) reported that the incidence of CSF leakage was 7.5% in their case series after EEEA.…”

Section: Discussionmentioning

confidence: 99%

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Comparative analysis of outcomes following craniotomy and expanded endoscopic endonasal approach resection of tuberculum sellae meningiomas: a single-institution study

Feng

Cao

et al. 2023

Front. Neurol.

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BackgroundTraditionally, supratentorial craniotomy has been used to sever tuberculum sellae meningiomas (TSMs), but there has been a remarkably increasing tendency of extended endoscopic endonasal approach (EEEA) used to treat TSMs in the recent decade. Several documents have described the advantages and disadvantages of both approaches, but there is no consensus on whether one is superior to the other.ObjectiveThis study aimed to compare surgical outcomes between craniotomy and EEEA for TSMS treated at our institution.MethodsFrom January 2015 to December 2021, a total of 84 cases of TSMs were included in this study. Cases were separated into two groups: the craniotomy group and the EEEA group. Their anamneses and surgical records were reviewed. Demographic data, presenting symptoms, tumor volume, extent of resection, visual outcomes, and follow-up data were tabulated. The Kaplan–Meier curves were constructed for the PFS for both cohorts.ResultsComplete data were available for 84 surgeries; 39 cases were treated via craniotomy, and 45 were treated via EEEA. Patient demographic data, pre-operative symptoms, and tumor characteristics were similar between the two cohorts. The extent of resection was similar between the two groups (GTR: 91.11% EEEA vs. 87.18% craniotomy; STR 8.89 vs. 12.82%, p = 0.91). There was no difference in visual outcomes between both groups (92.1 vs. 84.84%, p = 0.46). An increased rate of cranial nerve injury was noted in the craniotomy group (0 vs. 10.25%, p = 0.04). Post-operative CSF leak rate occurred in one patient in the EEEA group. The PFS curves (p = 0.52) and recurrence/progression rates (13.33 vs. 20.51%, p = 0.39) were similar between the two groups.ConclusionBoth EEEA and craniotomy can successfully sever TSMs. The recurrence/progression rate and PFS appear to be similar between the two groups. Although there are no differences in EOR and visual outcomes between the two groups, there was a clear trend in the EEEA group to obtain a better outcome. CSF leakage was common in the EEEA cohort, whereas the rate of cranial nerve injury was found to be higher in the craniotomy cohort. We believe that our data support the conclusion that EEEA surgery is the preferred approach for the removal of TSMs.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

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Comparative analysis of outcomes following craniotomy and expanded endoscopic endonasal approach resection of tuberculum sellae meningiomas: a single-institution study

Feng

Cao

et al. 2023

Front. Neurol.

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“…However, EEA showed advantages in terms of lower complication rates and shorter recovery time when compared to TCA. 28 Koutourousiou et al evaluated EEA for suprasellar meningiomas, including those involving the tuberculum sellae. The study showed promising results in terms of visual improvement and complete resection using the endoscopic technique.…”

Section: Discussionmentioning

confidence: 99%

Visual outcomes in tuberculum sellae meningiomas comparing transcranial and endoscopic endonasal approaches

Marian-Magaña,

Sangrador-Deitos,

Rodríguez-Hernández

et al. 2024

World Neurosurgery: X

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“…They found a higher rate of visual symptoms improvement (EES: 93% vs. TCS: 56%; p = 0.049) and a lower rate of visual function deterioration (EES: 0% vs. TCS: 44%; p = 0.012) among EES compared to TCS. Similarly, Jimenez et al [ 54 ] conducted a meta-analysis comparing the TCS and EES for suprasellar meningiomas. Their analysis showed that EES had significantly higher odds of visual improvement (Odds Ratio [OR] = 3.24, p = 0.0053) compared to TCS but had significantly higher odds of a cerebrospinal fluid leak (OR = 3.71, p = 0.0098) compared to TCS.…”

Section: Discussionmentioning

confidence: 99%

Tumors Involving the Infratemporal Fossa: A Systematic Review of Clinical Characteristics and Treatment Outcomes

Bin-Alamer

Bhenderu²,

Palmisciano³

et al. 2022

Cancers

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Background: Infratemporal fossa (ITF) tumors represent various pathologies and are seldom described in the literature, reflecting their rarity. Here we review the literature on tumors invading ITF and describe patient characteristics, treatment strategies, and clinical outcomes. Methods: Relevant articles were retrieved from PubMed, Scopus, and Cochrane. A systematic review and meta-analysis were conducted on the clinical presentation, treatment protocols, and clinical outcomes. Result: A total of 27 articles containing 106 patients with ITF tumors (median tumor size: 24.3 cm3 [interquartile range, 15.2–42 cm3]) were included (median age: 46 years [interquartile range, 32–55 years]; 59.4% were males]). Of the confirmed tumor pathology data, schwannomas (n = 24; 26.1%) and meningiomas (n = 13; 14.1%) were the most common tumors. Facial hypoesthesia (n = 22; 18.5%), auricular/preauricular pain (n = 20; 16.8%), and headaches (n = 11; 9.2%) were the most common presenting symptoms. Of patients who had surgical resection (n = 97; 95.1%), 70 (73.7%) had transcranial surgery (TCS) and 25 (26.3%) had endoscopic endonasal surgery (EES). Among available details on the extent of resection (n = 84), gross-total resection (GTR) was achieved in 62 (73.8%), and 5 (6.0%) had biopsy only. Thirty-five (33.0%) patients had postoperative complications. Among cases with available data on reconstruction techniques (n = 8), four (50%) had adipofascial antero-lateral thigh flap, three (37.5%) had latissimus dorsi free flap, and one (12.5%) had antero-lateral thigh flap. Fourteen (13.2%) patients had adjuvant chemotherapy, and sixteen (15.1%) had adjuvant radiotherapy. During a median follow-up time of 28 months (IQR, 12.25–45.75 months), 15 (14.2%) patients had recurrences, and 18 (17.0%) patients died. The median overall survival (OS) time was 36 months (95% confidence interval: 29–41 months), and the 5-year progression-free survival (PFS) rate was 61%. Conclusion: Various tumor types with different biological characteristics invade the ITF. The present study describes patient demographics, clinical presentation, management, and outcomes. Depending on the tumor type and patient condition, patient-tailored management is recommended to optimize treatment outcomes.

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Comparison and evolution of transcranial versus endoscopic endonasal approaches for suprasellar Meningiomas: A systematic review

Cited by 7 publications

References 68 publications

Comparative analysis of outcomes following craniotomy and expanded endoscopic endonasal approach resection of tuberculum sellae meningiomas: a single-institution study

Comparative analysis of outcomes following craniotomy and expanded endoscopic endonasal approach resection of tuberculum sellae meningiomas: a single-institution study

Visual outcomes in tuberculum sellae meningiomas comparing transcranial and endoscopic endonasal approaches

Tumors Involving the Infratemporal Fossa: A Systematic Review of Clinical Characteristics and Treatment Outcomes

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