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Comparison of the efficacy in improving trigeminal neuralgia in petroclival meningioma between microsurgery and radiosurgery: a meta-analysis

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Abstract

The purpose of this study was to systematically review studies in the literature to assess the superiority between microsurgery and radiosurgery regarding the efficacy in improving petroclival meningioma (PCM)-related trigeminal neuralgia (TN). PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched from the inception until December 08, 2022. The overall proportion of patients with improved TN after treatment in all six included studies was 56% (95% confidence interval [CI], 35–76.9%). Higgins I2 statistics showed significant heterogeneity (I2 = 90%). Subgroup analysis showed that the proportion of improved TN was higher in the microsurgery group than that in the radiosurgery group (89%; 95% CI, 81–96.5% vs. 37%, 95% CI, 22–52.7%, respectively, p < 0.01). Subgroup analysis (for studies that documented the number of posttreatment Barrow Neurological Institute scores 1 and 2) revealed that the proportion of pain-free without medication after treatment was higher in the microsurgery group than that in the radiosurgery group (90.7%; 95% CI, 81–99.7% vs. 34.5%, 95% CI, 21.3–47.7.7%, respectively, p < 0.01). Based on the results of this meta-analysis, we concluded that microsurgery is superior to radiosurgery in controlling PCM-related TN.

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Data availability

The authors confirm that the data supporting the findings of this study are available within its supplementary materials.

Code availability

Statistical analyses were performed using R software (version 4.0.4; The R Foundation for Statistical Computing, Vienna, Austria).

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Acknowledgements

We thank Jae Woong Jeon, a chairman of BORNTOBE Clinic, who gave us warm advice and help.

Funding

This research was conducted with the support of the special research fund from Korea University.

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Authors and Affiliations

  1. Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-Ro, Guro-Gu, Seoul, 08308, Korea

    Joonho Byun, Haewon Roh, Hyunjun Jo, Woo Keun Kwon, Won Ki Yoon, Taek Hyun Kwon & Jong Hyun Kim

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Contributions

JB conceived and designed the study. JB, HR, and HJ conducted the literature search. JB, WK, THK, and JHK were involved in the analysis and interpretation of data. JB drafted the manuscript. The study was supervised by JB and JHK. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jong Hyun Kim.

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Ethics approval

This meta-analysis has been approved by the appropriate ethics committee and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

The risk expected from this “meta-analysis” is not greater than the level I risk. In addition, all of the included patients’ dataset were anonymized. There is no reason to presume the refusal of the research subject’s consent, and the risk to the enrolled patients is extremely low even if consent is waived. Consent exemption does not infringe on the rights or welfare of the subject. It is not the research for drug/medical device approval, and it is not research regulated by a foreign regulatory agency.

Consent for publication

For this type of meta-analysis, formal consent from patients is not required.

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The authors declare no competing interests.

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Byun, J., Roh, H., Jo, H. et al. Comparison of the efficacy in improving trigeminal neuralgia in petroclival meningioma between microsurgery and radiosurgery: a meta-analysis. Neurosurg Rev 46, 314 (2023). https://doi.org/10.1007/s10143-023-02225-8

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