Lorenzo Giammattei1, Daniele Starnoni1, Marc Levivier2, Mahmoud Messerer2, Roy Thomas Daniel3. 1. Department of Clinical Neurosciences, Service of Neurosurgery and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland. 2. Department of Clinical Neurosciences, Service of Neurosurgery and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. 3. Department of Clinical Neurosciences, Service of Neurosurgery and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. Electronic address: roy.daniel@chuv.ch.
Abstract
OBJECTIVE: Clinoidal meningiomas present specific characteristics related to their peculiar site of anatomic origin. Clinical series focusing on pure clinoidal meningiomas are not numerous. We performed a systematic review and meta-analysis, including our own case series, of the available literature to better identify the specific features of these tumors. METHODS: A systematic review and meta-analysis were performed for surgically treated pure clinoidal meningiomas using PubMed, Cochrane, and Embase databases. A retrospective review of a cohort of 18 consecutive patients treated between 2010 and 2018 in our department was also included in this meta-analysis. RESULTS: A total of 1208 patients were included in the analysis. With a weighted mean follow-up of 48.1 months, the pooled rate of gross total resection was 64.2% (95% confidence interval [CI], 57.3%-71.0%) in the overall population, 11.8% (95% CI, 2.4%-21.1%) in the Al-Mefty I subgroup, 92.6% (95% CI, 88.9%-96.3%) in the Al-Mefty II subgroup, and 84.2% (95% CI, 70.8%-97.6%) in the Al-Mefty III subgroup. Overall visual improvement after treatment was found in 48% (95% CI, 38.6%-57.4%) of patients with a pooled deterioration rate of 4.5% (95% CI, 3%-6%). Pooled overall recurrence was observed in 8.9% of patients (95% CI, 6.0%-11.8%) and mortality occurred in 1.2% (95% CI, 0.6%-1.8%). CONCLUSIONS: The rate of gross total resection is proportional to the dural origin of these tumors, which is intimately related to critical neurovascular structures. Complementary radiosurgery could represent a valid treatment strategy. Postoperative visual improvement remains less satisfying compared with other suprasellar meningiomas. The introduction of skull-base techniques, such as extradural anterior clinoidectomy, has enabled improvements in visual outcome without any increase in approach-related morbidity.
OBJECTIVE:Clinoidal meningiomas present specific characteristics related to their peculiar site of anatomic origin. Clinical series focusing on pure clinoidal meningiomas are not numerous. We performed a systematic review and meta-analysis, including our own case series, of the available literature to better identify the specific features of these tumors. METHODS: A systematic review and meta-analysis were performed for surgically treated pure clinoidal meningiomas using PubMed, Cochrane, and Embase databases. A retrospective review of a cohort of 18 consecutive patients treated between 2010 and 2018 in our department was also included in this meta-analysis. RESULTS: A total of 1208 patients were included in the analysis. With a weighted mean follow-up of 48.1 months, the pooled rate of gross total resection was 64.2% (95% confidence interval [CI], 57.3%-71.0%) in the overall population, 11.8% (95% CI, 2.4%-21.1%) in the Al-Mefty I subgroup, 92.6% (95% CI, 88.9%-96.3%) in the Al-Mefty II subgroup, and 84.2% (95% CI, 70.8%-97.6%) in the Al-Mefty III subgroup. Overall visual improvement after treatment was found in 48% (95% CI, 38.6%-57.4%) of patients with a pooled deterioration rate of 4.5% (95% CI, 3%-6%). Pooled overall recurrence was observed in 8.9% of patients (95% CI, 6.0%-11.8%) and mortality occurred in 1.2% (95% CI, 0.6%-1.8%). CONCLUSIONS: The rate of gross total resection is proportional to the dural origin of these tumors, which is intimately related to critical neurovascular structures. Complementary radiosurgery could represent a valid treatment strategy. Postoperative visual improvement remains less satisfying compared with other suprasellar meningiomas. The introduction of skull-base techniques, such as extradural anterior clinoidectomy, has enabled improvements in visual outcome without any increase in approach-related morbidity.
Authors: Rafael Martinez-Perez; Thiago Albonette-Felicio; Douglas A Hardesty; Ricardo L Carrau; Daniel M Prevedello Journal: Neurosurg Rev Date: 2020-05-11 Impact factor: 3.042
Authors: Rafael Martinez-Perez; Douglas A Hardesty; Giuliano Silveira-Bertazzo; Thiago Albonette-Felicio; Ricardo L Carrau; Daniel M Prevedello Journal: Neurosurg Rev Date: 2020-05-26 Impact factor: 3.042
Authors: Henry Ruiz-Garcia; Daniel M Trifiletti; Nasser Mohammed; Yi-Chieh Hung; Zhiyuan Xu; Tomas Chytka; Roman Liscak; Manjul Tripathi; David Arsanious; Christopher P Cifarelli; Marco Perez Caceres; David Mathieu; Herwin Speckter; Gautam U Mehta; Gregory P Lekovic; Jason P Sheehan Journal: J Neurol Surg B Skull Base Date: 2021-01-19
Authors: D Starnoni; C Tuleasca; L Giammattei; G Cossu; M Bruneau; M Berhouma; J F Cornelius; L Cavallo; S Froelich; E Jouanneau; T R Meling; D Paraskevopoulos; H Schroeder; M Tatagiba; I Zazpe; A Sufianov; M E Sughrue; Ari G Chacko; V Benes; P González-Lopez; Pierre-Hugues Roche; Marc Levivier; Mahmoud Messerer; Roy T Daniel Journal: Acta Neurochir (Wien) Date: 2021-08-16 Impact factor: 2.216
Authors: Udom Bawornvaraporn; Ali R Zomorodi; Allan H Friedman; Takanori Fukushima Journal: Acta Neurochir (Wien) Date: 2021-07-10 Impact factor: 2.216