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dc.contributor.authorKhan, Danyal Z.
dc.contributor.authorMuskens, Ivo S.
dc.contributor.authorMekary, Rania A.
dc.contributor.authorZamanipoor Najafabadi, Amir H.
dc.contributor.authorHelmy, Adel E.
dc.contributor.authorReisch, Robert
dc.contributor.authorBroekman, Marike L. D.
dc.contributor.authorMarcus, Hani J.
dc.date.accessioned2021-02-16T16:18:10Z
dc.date.available2021-02-16T16:18:10Z
dc.date.issued2020-09-05
dc.date.submitted2020-06-03
dc.identifier.issn0001-6268
dc.identifier.others00701-020-04544-x
dc.identifier.other4544
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/317730
dc.description.abstractAbstract: Introduction: The gold-standard treatment for symptomatic anterior skull base meningiomas is surgical resection. The endoscope-assisted supraorbital “keyhole” approach (eSKA) is a promising technique for surgical resection of olfactory groove (OGM) and tuberculum sellae meningioma (TSM) but has yet to be compared with the microscopic transcranial (mTCA) and the expanded endoscopic endonasal approach (EEA) in the context of existing literature. Methods: An updated study-level meta-analysis on surgical outcomes and complications of OGM and TSM operated with the eSKA, mTCA, and EEA was conducted using random-effect models. Results: A total of 2285 articles were screened, yielding 96 studies (2191 TSM and 1510 OGM patients). In terms of effectiveness, gross total resection incidence was highest in mTCA (89.6% TSM, 91.1% OGM), followed by eSKA (85.2% TSM, 84.9% OGM) and EEA (83.9% TSM, 82.8% OGM). Additionally, the EEA group had the highest incidence of visual improvement (81.9% TSM, 54.6% OGM), followed by eSKA (65.9% TSM, 52.9% OGM) and mTCA (63.9% TSM, 45.7% OGM). However, in terms of safety, the EEA possessed the highest cerebrospinal fluid leak incidence (9.2% TSM, 14.5% OGM), compared with eSKA (2.1% TSM, 1.6% OGM) and mTCA (1.6% TSM, 6.5% OGM). Finally, mortality and intraoperative arterial injury were 1% or lower across all subgroups. Conclusions: In the context of diverse study populations, the eSKA appeared not to be associated with increased adverse outcomes when compared with mTCA and EEA and offered comparable effectiveness. Case-selection is paramount in establishing a role for the eSKA in anterior skull base tumours.
dc.languageen
dc.publisherSpringer Vienna
dc.rightsAttribution 4.0 International (CC BY 4.0)en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectOriginal Article - Tumor - Meningioma
dc.subjectTumor – Meningioma
dc.subjectEndoscopic transsphenoidal surgery
dc.subjectMicroscopic transcranial surgery
dc.subjectSupraorbital keyhole
dc.subjectSkull base surgery
dc.subjectTuberculum Sellae Meningioma
dc.subjectOlfactory groove meningioma
dc.titleThe endoscope-assisted supraorbital “keyhole” approach for anterior skull base meningiomas: an updated meta-analysis
dc.typeArticle
dc.date.updated2021-02-16T16:18:09Z
prism.endingPage676
prism.issueIdentifier3
prism.publicationNameActa Neurochirurgica
prism.startingPage661
prism.volume163
dc.identifier.doi10.17863/CAM.64844
dcterms.dateAccepted2020-08-16
rioxxterms.versionofrecord10.1007/s00701-020-04544-x
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidKhan, Danyal Z. [0000-0001-9213-2550]
dc.identifier.eissn0942-0940


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's licence is described as Attribution 4.0 International (CC BY 4.0)