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Endoscopic versus Open Resection of Tuberculum Sellae Meningiomas: A Decision Analysis.
- Source :
- ORL; Jan2013, Vol. 74 Issue 5, p255-263, 9p
- Publication Year :
- 2013
-
Abstract
- Background/Aims: Tuberculum sellae meningiomas (TSMs) are challenging tumors for surgical resection. Endoscopic endonasal (EE) approaches to these lesions have not been directly compared to open craniotomy in a controlled trial. Methods: We searched Medline and Embase online databases for English-language articles containing key words related to TSMs. Data were pooled, including 5 of our own patients reported here for the first time. Metaregression was used and a decision-analytical model was constructed to compare outcomes between open microsurgery and EE approaches. Results: The overall quality of life (QOL) was not significantly different between the approaches (p = 0.410); however, there were large differences in individual complication rates. The Monte Carlo simulation yielded an overall average QOL in craniotomy patients of 0.915 and in endoscopic patients of 0.952. Endoscopy had a higher CSF leak rate (26.8 vs. 3.5%, p < 0.001) but a lower rate of injury to the optic apparatus (1.4 vs. 9.2%, p < 0.001) compared with craniotomy. The 3-year recurrence rates were not statistically different (p = 0.529). Conclusion: EE resection of TSMs appears to be a comparable alternative to traditional open microsurgical resection with respect to overall QOL based on available publications. A meaningful comparison of recurrence rates will require a longer follow-up. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Subjects :
- ENDOSCOPIC surgery
TUMOR surgery
PRECANCEROUS conditions
CRANIOTOMY
MENINGIOMA
Subjects
Details
- Language :
- English
- ISSN :
- 03011569
- Volume :
- 74
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- ORL
- Publication Type :
- Academic Journal
- Accession number :
- 84630783
- Full Text :
- https://doi.org/10.1159/000343794