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Petroclival meningiomas: the risk of post-operative cranial nerve deficits among different surgical approaches—a systematic review and meta-analysis

  • Original Article - Tumor - Meningioma
  • Published:
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Abstract

Background

The surgical resection of petroclival meningiomas (PCMs) remains a challenge. Both the relationship with neurovascular structures and the deep location of the tumor can affect the extent of resection and the rate of post-operative morbidity.

Methods

The authors performed a systematic review and meta-analysis of the literature examining the rate of new cranial nerve (CN) deficits after resection of PCM. A systematic search of two databases was performed for studies published between 1990 and 2018. Random-effect meta-analysis was used to pool the rate of post-operative CN deficits, mortality rate, and rate of radical resection.

Results

We included twelve studies and 334 patients harboring PCM. The overall rate of complete resection was 68% (95% CI 57.9–78.2%; p < 0.01; I2 = 83%). The rate of early and late post-operative CN deficits was the following: 3.8 and 2.7% (III CN), 6.6 and 3% (IV), 7.3 and 5.5% (V CN), 8 and 3.6% (VI CN), 8.9 and 8.9%% (VIII), and 4 and 2.7% (IX-XI CNs) (I2 = 0%, and p < 0.01 for all analyses). The risk of post-operative deficit of the IV CN was higher among the petrosal group (7.6%; I2 = 0% vs 2.1%; I2 = 0%), whereas the impairment of VII CN function was higher among retrosigmoid group (16.6%; I2 = 64.6% vs 11.4%; I2 = 52.8%), but it was transient in the majority of cases.

Conclusions

This systematic review and meta-analysis provides a detailed overview of post-operative CN deficits ensuing surgical resection of PCMs. These findings should be acknowledged when counseling patients with PCMs regarding the more appropriate approach for their tumor.

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Acknowledgments

We thank Prof. Beth De Felici for the English revision.

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Authors and Affiliations

  1. Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Via Paradisa 2, 56100, Pisa, Italy

    Davide Tiziano Di Carlo, Arianna Fava & Paolo Perrini

  2. Neurosurgical Department, Lariboisière Hospital, Université Paris Diderot, Paris, France

    Davide Tiziano Di Carlo, Gabriele Capo, Arianna Fava, Miguel Margil-Sànchez, Pierre-Olivier Champagne, Eduard H. J. Voormolen & Sébastien Froelich

  3. Neuroradiology Department, University Hospital Gui-de-Chauliac, CHU de Montpellier, Montpellier, France

    Federico Cagnazzo

  4. Department of Clinical and Experimental Medicine, Section of Statistics, University of Pisa, Pisa, Italy

    Riccardo Morganti

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  1. Davide Tiziano Di Carlo
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Correspondence to Davide Tiziano Di Carlo.

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Di Carlo, D.T., Capo, G., Fava, A. et al. Petroclival meningiomas: the risk of post-operative cranial nerve deficits among different surgical approaches—a systematic review and meta-analysis. Acta Neurochir 162, 2135–2143 (2020). https://doi.org/10.1007/s00701-020-04395-6

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