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Endoscopic versus Open Resection of Tuberculum Sellae Meningiomas: A Decision Analysis.
MedLine Citation:
PMID:  23107968     Owner:  NLM     Status:  Publisher    
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.
Leif-Erik Bohman; Sherman C Stein; Jason G Newman; James N Palmer; Nithin D Adappa; Aamir Khan; T T Sitterley; Diana Chang; John Y K Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-26
Journal Detail:
Title:  ORL; journal for oto-rhino-laryngology and its related specialties     Volume:  74     ISSN:  1423-0275     ISO Abbreviation:  ORL J. Otorhinolaryngol. Relat. Spec.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0334721     Medline TA:  ORL J Otorhinolaryngol Relat Spec     Country:  -    
Other Details:
Languages:  ENG     Pagination:  255-263     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Department of Neurosurgery, University of Pennsylvania Health System, Philadelphia, Pa., USA.
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