Efficiency and safety of optic canal unroofing in tuberculum sellae meningiomas: a meta-analysis and systematic review

AbstractOptic canal unroofing (OCU) has gradually become a routine technique for tuberculum sellae meningiomas (TSMs) resection. This meta-analysis aimed to evaluate the efficacy and safety of OCU. A systematic review and meta-analysis of the published literature on this topic from 2003 to 2023 were conducted in accordance with the PRISMA guidelines. Rigorous statistical analysis with ap-value was performed for related change in visual improvement, gross total resection (GTR), visual deterioration, and olfactory nerve damage. The study included 15 articles with 384 patients in whom OCU was performed by the transcranial approach (TCA) or the endoscopic endonasal approach (EEA). Of these, 341 patients had preoperative visual loss, and 266 patients had postoperative visual recovery. The overall rate of visual improvement was 0.803 (95% CI: 0.733 –0.874,p <  0.01). The rate of visual improvement in the EEA and TCA groups was 0.884 (95% CI: 0.803–0.965,p <  0.01) and 0.788 (95% CI: 0.700–0.875,p <  0.01). Further analysis of classification shows that the rate of visual improvement in Type I: <  2 cm was 0.889(95% CI: 0.739–0.969), Type II:2-4 cm was 0.844(95% CI: 0.755–0.910), Type III: >  4 cm was 0.500(95% CI: 0.068–0.932) and the total was 0.853(95% CI: 0.779–0.927p <  0.01) with low heterogeneity of I2 = 20.80%.Twelve studies separately reported GTR with OCU was 293; the rate of GTR was 0.911 (95% CI: 0.848–0.961...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research