Combined petrosal approach: a systematic review and meta-analysis of surgical complications.

Details

Ressource 1Download: 37439884_BIB_621EC3A88D53.pdf (1067.59 [Ko])
State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_621EC3A88D53
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Combined petrosal approach: a systematic review and meta-analysis of surgical complications.
Journal
Neurosurgical review
Author(s)
Giammattei L., Starnoni D., Peters D., George M., Messerer M., Daniel R.T.
ISSN
1437-2320 (Electronic)
ISSN-L
0344-5607
Publication state
Published
Issued date
13/07/2023
Peer-reviewed
Oui
Volume
46
Number
1
Pages
172
Language
english
Notes
Publication types: Meta-Analysis ; Systematic Review ; Journal Article ; Review
Publication Status: epublish
Abstract
Transpetrosal approaches are known to be associated with a significant risk of complications, including CSF leak, facial palsy, hearing impairment, venous injury, and/or temporal lobe injury. We aimed to evaluate the morbidity of the standard combined petrosal approach (CPA), defined as a combination of the posterior (retrolabyrinthine) and the anterior petrosal approach. We performed a systematic review and meta-analysis of articles reporting on clinical series of patients operated on for petroclival meningiomas through CPA. Studies that used the terminology "combined petrosal approach" without matching the aforementioned definition were excluded as well as clinical series that included less than 5 patients. A total of 8 studies were included involving 160 patients. The pooled complication rates were 3% (95% CI, 0.5-5.6) for CSF leak, 8.6% (95% CI, 4.1-13.2%) for facial palsy, 8.2% (95% CI, 3.9-12.6%) for hearing impairment, 2.8% (95% CI, 0.9-6.5%) for venous complications, and finally 4.8% (95%, 1.2-8.4%) for temporal lobe injury. Contrary to the general belief, CPA is associated with an acceptable rate of complications, especially when compared to alternative approaches to the petroclival area. In view of the major advantages like shorter trajectory, multiple angles of surgical attack, and early tumor devascularization, CPA remains an important tool in the armamentarium of the skull base surgeon.
Keywords
Humans, Facial Paralysis/etiology, Neurosurgical Procedures/adverse effects, Meningioma/surgery, Meningioma/pathology, Meningeal Neoplasms/surgery, Meningeal Neoplasms/pathology, Hearing Loss/surgery, Hearing Loss/etiology, Petrous Bone/surgery, Combined petrosal approach, Combined transpetrosal approach, Petrosal approaches, Presigmoid approach, Retrolabyrinthine approach
Pubmed
Web of science
Open Access
Yes
Create date
14/07/2023 13:39
Last modification date
08/08/2024 7:34
Usage data