Journal of Neurological Surgery Part B: Skull Base最新文献_第5页

CURRENT EVIDENCE IN THE MANAGEMENT OF CENTRAL SKULL BASE OSTEOMYELITIS- A SYSTEMATIC REVIEW 治疗中枢性颅底骨髓炎的现有证据--系统回顾

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-02 DOI: 10.1055/a-2297-9474

L. Penubarthi, G. Upreti, Sabharisan Paramasivam, Sivaraman Ganesan, Arun Alexander, Regi Thomas

{"title":"CURRENT EVIDENCE IN THE MANAGEMENT OF CENTRAL SKULL BASE OSTEOMYELITIS- A SYSTEMATIC REVIEW","authors":"L. Penubarthi, G. Upreti, Sabharisan Paramasivam, Sivaraman Ganesan, Arun Alexander, Regi Thomas","doi":"10.1055/a-2297-9474","DOIUrl":"https://doi.org/10.1055/a-2297-9474","url":null,"abstract":"Objectives: Based on current evidence, this systematic review focuses on various grey areas related to these patients' diagnosis, management and follow-up in central skull base osteomyelitis (CSBO).\u0000Study design: A systematic review of all case reports and observational studies.\u0000Methods: We systematically searched PubMed, Scopus database, Cochrane database, UK clinicaltrails.gov registry, and WHO ICTRP and included all reports as per our inclusion criteria. Data was analyzed systematically, and we made essential observations.\u0000Results: Out of 179 articles, 25 were selected according to inclusion criteria and quality assessment. Among the 44 patients, refractory headache (95%) was the most common presentation, followed by cranial nerve paralysis (82%) and Pseudomonas (32%) as the most common bacteria. Contrary to the available literature the disease cure was worse in those who underwent targeted biopsy (64% VS 36%, P = 0.023) and surgical debridement (61% vs 39%, P = 0.013) in the late stages of the disease.\u0000Conclusions: Otogenic osteomyelitis can spread to central skull bones in the absence of obvious ear symptoms. Early diagnosis and intervention of CSBO before progression to late stages can help decrease significant morbidity and mortality. \u0000","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Network Analysis of Past Presidents of the North American Skull Base Society 北美颅底协会前任主席网络分析

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-02 DOI: 10.1055/a-2297-9267

J. Luebs, C. Snyderman

{"title":"Network Analysis of Past Presidents of the North American Skull Base Society","authors":"J. Luebs, C. Snyderman","doi":"10.1055/a-2297-9267","DOIUrl":"https://doi.org/10.1055/a-2297-9267","url":null,"abstract":"BACKGROUND: Little is known about the relative contributions and interactions of the past presidents of the North American Skull Base Society (NASBS) and skull base centers. \u0000OBJECTIVES: (1) Measure academic contributions of past presidents; (2) Identify influential nodes of academic collaboration; (3) Identify opportunities for future collaboration. \u0000METHODS: Peer reviewed publications of past presidents of NASBS from 1964 to July 2019 were identified using Scopus author name search. Network structures were constructed and analyzed using the graph-tool python library to produce a weighted co-authorship network base and compute centrality measures. Girvan-Newman clustering was applied to identify community structure. Network maps were then produced using Gephi network visualization software with force-directed layout algorithms.\u0000RESULTS: The coauthor network of 29 presidents was fully connected, with a maximum shortest-path distance between presidents of 5. The mean number of connections from each node without respect to weighting was 5.31 (SD 3.53), and the mean number of connections with weighting was 8.40 (SD 7.28). The number of unweighted connections ranged from 1-14 and weighted connections ranged from 0.25-24.7. Girvan-Newman clustering identified 3 communities with 2 that covered 93% of the network. The largest communities contained 14 and 13 presidents. The number of connections was correlated with h-index, both unweighted (r2=0.34) and weighted (r2=0.26).\u0000CONCLUSIONS: Network mapping of past presidents of the NASBS helps to capture the history of the NASBS and reveals areas of concentration and influence within the specialty.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140752964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic Endonasal Anterior Skull Base Meningoencephalocele and Cerebrospinal Fluid Leak Repair: Our Intraoperative and Postoperative Protocol and Long-Term Outcomes 内窥镜下颅底前脑膜脑脊液漏修补术：我们的术中、术后方案和长期疗效

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-02 DOI: 10.1055/a-2297-9386

Gianna M. Ruiz, Zachary Uram, Oleksandr Strelko, A. Hossain, Isaac B. Ng, Chirag Patel, Anand V. Germanwala

{"title":"Endoscopic Endonasal Anterior Skull Base Meningoencephalocele and Cerebrospinal Fluid Leak Repair: Our Intraoperative and Postoperative Protocol and Long-Term Outcomes","authors":"Gianna M. Ruiz, Zachary Uram, Oleksandr Strelko, A. Hossain, Isaac B. Ng, Chirag Patel, Anand V. Germanwala","doi":"10.1055/a-2297-9386","DOIUrl":"https://doi.org/10.1055/a-2297-9386","url":null,"abstract":"Objective: \u0000We evaluated the long-term outcomes from a single neurosurgeon and otolaryngologist team using a specific operative protocol for repair and postoperative evaluation. \u0000Design: \u0000The charts of patients undergoing endoscopic endonasal repair of meningoencephaloceles (MECs) and cerebrospinal fluid (CSF) leaks were retrospectively reviewed from 2015 - 2023. Intraoperative steps of the repair and reconstruction were analyzed. Patients' postoperative assessments and complications were analyzed. \u0000Setting: \u0000Loyola University Medical Center’s electronic medical record database \u0000Participants: \u000043 patients (32 female) between 11-81 years old.\u0000Main Outcome Measures: \u0000Long-term outcomes of patients that underwent endoscopic endonasal repair of MECs and CSF leaks by a single team and protocol. We hypothesized that there would be minimal complications and no recurrences, requiring secondary operation. \u0000Results: \u0000The most common site for MECs was the cribriform plate. Lumbar drain opening pressures ranged from 10 to 35 cmH2O with 18 out of 34 patients having the lumbar drain removed immediately postoperatively. The median hospital stay was 3 days. The average length of follow up was 3.8 years. No recurrences or secondary operations were noted in all patients. One patient had a sinonasal infection that was successfully treated. 8 patients were noted to have venous stenosis and underwent further evaluation. \u0000Conclusion: This study represents one of the largest long-term analyses of outcomes by a single team. Our specific protocol for the endoscopic endonasal repair of anterior skull base MECs and CSF leaks is safe and effective. These patients should be evaluated and treated for elevated intracranial pressure following the repair.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epilepsy in Association with Giant Skull Base Tumors: A Retrospective Case Series of Giant Skull Base Tumors in the Anterior and Middle Fossa. 与巨大颅底肿瘤相关的癫痫：前窝和中窝巨大颅底肿瘤的回顾性病例系列。

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-02 DOI: 10.1055/a-2297-8981

B. Edelbach, Miguel A. Lopez-Gonzalez

{"title":"Epilepsy in Association with Giant Skull Base Tumors: A Retrospective Case Series of Giant Skull Base Tumors in the Anterior and Middle Fossa.","authors":"B. Edelbach, Miguel A. Lopez-Gonzalez","doi":"10.1055/a-2297-8981","DOIUrl":"https://doi.org/10.1055/a-2297-8981","url":null,"abstract":"Objective\u0000This study aims to investigate the association between giant anterior and middle fossa skull base tumors and epilepsy, and implications for clinical management.\u0000Methods\u0000A retrospective analysis was conducted on a cohort of patients diagnosed with anterior skull base tumors between 2016 and 2023. Radiologic data was used to identify tumors with major diameter larger than 5cm involving skull base with intracranial involvement. Relevant demographic information, tumor characteristics, seizure type, seizure frequency, and treatment outcomes were analyzed.\u0000Results\u0000 Among the 236 patients diagnosed and operated with skull base tumors by senior author, 7.63 percent (n=18) had giant skull base tumors of anterior and middle fossa, and 2.96 percent (n=7) presented with concurrent epilepsy. Overall, in giant anterior and middle fossa skull base tumors, epilepsy was present in 38% of cases. The average age at operation was 47.56 ±16.96, with 44.4% of cases male and 55.6% of the cases female. The majority of these cases exhibited focal epilepsy (71 %), characterized by seizures originating from the proximity of the tumor location suggesting a potential correlation between tumor location and seizure generation. Of the remaining, 29% were generalized seizures. Tumors of the anterior fossa included 11 meningiomas, 3 pituitary adenomas, 1 chondrosarcoma, 1 hemangioperycitoma, 1 schwannoma, and 1 adenoid cyst carcinoma, half of which (n=9) were of low grade. \u0000Conclusion\u0000Our findings provide evidence of low frequency of epilepsy in skull base tumors in general, although a significant association among giant anterior and middle fossa skull base tumor and epilepsy.\u0000","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of the lumbar catheter on the incidence of post-surgical meningitis in the endoscopic endonasal approach 腰部导管对内窥镜鼻内入路手术后脑膜炎发生率的影响

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-02 DOI: 10.1055/a-2298-0898

L. P. Maskin, S. E. Noya, G. Caffaratti, María Martina Echarri, Alejandro F Hlavnicka, A. Cervio

{"title":"Impact of the lumbar catheter on the incidence of post-surgical meningitis in the endoscopic endonasal approach","authors":"L. P. Maskin, S. E. Noya, G. Caffaratti, María Martina Echarri, Alejandro F Hlavnicka, A. Cervio","doi":"10.1055/a-2298-0898","DOIUrl":"https://doi.org/10.1055/a-2298-0898","url":null,"abstract":"Objectives: Endoscopic endonasal approach (EEA) procedures are inherently contaminated due to direct access through the nasopharyngeal mucosa. The reported rate of postoperative meningitis in EEA procedures is between 0.7%-10%. Lumbar catheters are used in EEA surgeries to prevent cerebrospinal fluid (CSF) fistulae, but its use is associated with increase infection rates. This study investigated whether there is a difference in rates of postoperative meningitis based on lumbar catheter utilization. \u0000Methods: We performed a retrospective review of consecutive patients who underwent EEA surgeries between January 2016 and March 2023 at single-institution (FLENI). \u0000Main outcome: Incidence of meningitis following EEA surgery with lumbar catheter.\u0000Results: seventy-two patients were enrolled, median age was 44 years, and 53% were female. Most frequent surgery performed was craniopharyngioma 46% (26 patients). Lumbar catheter was used in twenty-eight patients. Meningitis was diagnosis in 11 of 72 patients (15.2%), being higher in the lumbar catheter group (10 patients). The odds ratio for the development of meningitis in the presence of a lumbar catheter was 23.38 (95% confidence interval, 2.77-123.78; p < 0.004). There was no statistical difference in reported incidence of meningitis when CSF leak was present. \u0000Conclusions: This study demonstrates an extremely high incidence of meningitis (36%) following EEA procedures when lumbar catheter is used. The incidence of meningitis was not significantly associated with CSF leak in our cohort.\u0000","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Network Analysis of the North American Skull Base Society Membership 北美颅底协会会员网络分析

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-02 DOI: 10.1055/a-2297-9338

J. Luebs, C. Snyderman

{"title":"Network Analysis of the North American Skull Base Society Membership","authors":"J. Luebs, C. Snyderman","doi":"10.1055/a-2297-9338","DOIUrl":"https://doi.org/10.1055/a-2297-9338","url":null,"abstract":"BACKGROUND: The membership of the North American Skull Base Society (NASBS) has grown considerably in recent years with diversity in subspecialty training, gender, and geography. The academic relationships and contributions of its membership has not been studied.\u0000OBJECTIVES: (1) Measure academic contributions of NASBS membership; (2) Identify influential nodes of academic collaboration; (3) Identify opportunities for future collaboration and mentorship. \u0000METHODS: Peer reviewed publications of members of NASBS (2019 NASBS website) were identified using Scopus author name search. Network structures were constructed and analyzed using the graph-tool python library to produce a weighted co-authorship network and compute centrality measures. Visual network maps were then produced using Gephi network visualization software. \u0000RESULTS: The coauthor network contained 952 members with found publications and 4996 connections. 846 (88.9%) members were contained in a single connected giant component. 102 members were unconnected and 64 members had a single connection. Girvan-Newman clustering identified 267 communities, where 13 contained at least 1% of the total membership each. The 3 largest communities contained 23.3%, 8.4%, and 6.9% of members. \u0000There were 111 published members identified as women. 5.4% of women were unconnected vs 11.4% of men. Average publication count for women was 32.3 (SD 38.5) vs 70.5 (SD 106) for men. Average citation count for women was 543 (SD 1012) vs 1389 (SD 2893) for men.\u0000CONCLUSIONS: Network mapping of membership of the NASBS helps to visualize the academic activities and relationships of the NASBS and reveals areas of concentration and influence within the specialty.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giant Meningiomas Invading the Cavernous Sinus: The “Inevitable Ones” 侵入海绵窦的巨型脑膜瘤：不可避免的肿瘤

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-28 DOI: 10.1055/a-2273-5509

Carlos Eduardo da Silva, Tamara Vidaletti

{"title":"Giant Meningiomas Invading the Cavernous Sinus: The “Inevitable Ones”","authors":"Carlos Eduardo da Silva, Tamara Vidaletti","doi":"10.1055/a-2273-5509","DOIUrl":"https://doi.org/10.1055/a-2273-5509","url":null,"abstract":"\u0000Introduction Giant meningiomas invading the cavernous sinus (GMICSs) are a subgroup of challenging tumors due to their volume and the extent of neurological impairment. Preserving quality of life is one of the most relevant aspects of treating patients with GMICS. \u0000Methods A retrospective study was conducted for surgeries performed between 2012 and 2022, including 33 patients presenting meningiomas with the largest diameter of at least 5 cm invading the cavernous sinus. The data from surgical intervention, Simpson grade of resection, tumor location, and morbimortality related to the surgeries were reviewed. \u0000Results The group comprised 25 women and 8 men with a median age of 56 years. The mean follow-up period was 52 months. The tumors were in the sphenoid wing, anterior clinoid, spheno-orbital, spheno-petroclival, petroclival, and Meckel's cave. Simpson grade I, II, and III were obtained in 70% of cases. The meningiomas were classified as WHO grade 1 in 94%, grade 2 in 3%, and grade 3 in 3%. The overall mortality was 3%. Permanent cranial nerve deficits occurred in 21%, transient cranial nerve deficits in 42%, cerebrospinal fistula in 15%, and hemiparesis in 18%. The recurrence/regrowth rate was 6%. The Karnofsky Performance Status score of 100 and 90 was 82%. \u0000Conclusions The surgical treatment of GMICS is an effective treatment modality with acceptable morbimortality and good long-term control. Involvement of the internal carotid artery is essential to determine the extent of resection inside the cavernous sinus, and training in the microsurgical laboratory is mandatory for safe surgical treatment. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140323420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum: Grade 3 Meningioma Survival and Recurrence Outcomes in an International Multicenter Cohort. 更正：国际多中心队列中3级脑膜瘤的生存和复发结果。

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-14 eCollection Date: 2024-02-01 DOI: 10.1055/s-0044-1782669

Kira Tosefsky, Alexander D Rebchuk, Justin Z Wang, Yosef Ellenbogen, Richard Drexler, Franz L Ricklefs, Thomas Sauvigny, Ulrich Schüller, Christopher B Cutler, Brandon Lucke-Wold, Yusuf Mehkri, Sanju Lama, Garnette R Sutherland, Michael Karsy, Brian L Hoh, Manfred Westphal, Gelareh Zadeh, Stephen Yip, Serge Makarenko

引用次数: 0

Optimal Screening for Hereditary Head and Neck Paraganglioma in Asymptomatic SDHx Variant Carriers in the Netherlands 荷兰对无症状 SDHx 变异携带者进行遗传性头颈部副神经管瘤的最佳筛查

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1781438

Anouk Frederique Heesters, Carli Tops, Thomas Potjer, Eleonora P.M. Corssmit, Jean-Pierre Bayley, Erik Hensen, Jeroen Jansen

{"title":"Optimal Screening for Hereditary Head and Neck Paraganglioma in Asymptomatic SDHx Variant Carriers in the Netherlands","authors":"Anouk Frederique Heesters, Carli Tops, Thomas Potjer, Eleonora P.M. Corssmit, Jean-Pierre Bayley, Erik Hensen, Jeroen Jansen","doi":"10.1055/s-0044-1781438","DOIUrl":"https://doi.org/10.1055/s-0044-1781438","url":null,"abstract":"\u0000Background SDHx variant carriers have an increased risk of developing head and neck paraganglioma. The Dutch guidelines state that these patients require lifelong follow-up, but no clear recommendation is made about the frequency of screening. \u0000Objective To determine the annual risk of developing head and neck paraganglioma in SDHx variant carriers after a negative initial screening. \u0000Methods We conducted a retrospective single-center cohort study in the Netherlands that included 49 SDHA, SDHB, and SDHD variant carriers with a negative first screening and at least one follow-up. The main outcome measure was the annual risk of developing a paraganglioma for the SDHx variants separately. \u0000Results Between 2000 and 2022, nine patients developed a paraganglioma all of whom were carriers of a SDHD variant (n = 23). Neither the 24 SDHB-related cases nor the 2 SDHA variant carriers developed a paraganglioma after a median of 4.83 and 5.92 years of follow-up, respectively. \u0000Conclusion The 5-year risk for head and neck paragangliomas in pathological SDHx variant carriers is less than 20%. A 5-year interval for screening SDHx carriers seems sufficient to prevent the unnoticed development of head and neck paragangliomas that warrant treatment. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complications of Endonasal Odontoidectomy in Pediatric versus Adult Populations: A Systematic Review and Meta-Analysis 儿童与成人鼻内舌骨切除术的并发症：系统回顾与元分析

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-01 DOI: 10.1055/a-2257-5439

Nikitha Kosaraju, Christine K. Lee, Z. Jason Qian, Juan C. Fernandez-Miranda, Jayakar V. Nayak, Michael T. Chang

{"title":"Complications of Endonasal Odontoidectomy in Pediatric versus Adult Populations: A Systematic Review and Meta-Analysis","authors":"Nikitha Kosaraju, Christine K. Lee, Z. Jason Qian, Juan C. Fernandez-Miranda, Jayakar V. Nayak, Michael T. Chang","doi":"10.1055/a-2257-5439","DOIUrl":"https://doi.org/10.1055/a-2257-5439","url":null,"abstract":"\u0000Introduction Endonasal odontoidectomy (EO) is a procedure for addressing compressive pathology of the craniovertebral junction. While EO has been well established in adults, its complications and cervical fusion practices are less understood in pediatric patients, despite differences in sinonasal and craniocervical anatomy. This study summarizes and compares EO complications and need for cervical fusion in pediatric and adult patients. \u0000Methods This was a systematic review and meta-analysis. Literature review was conducted using PubMed, Web of Science, and Embase to identify studies reporting complications post-EO in adult and pediatric patients. Complications were categorized as neurologic, swallowing, or respiratory. Complication and posterior fusion rates were compared using a random-effects model. \u0000Results A total of 738 articles were identified, of which 28 studies including 307 adult cases and 22 pediatric cases met inclusion criteria for systematic qualitative and quantitative review. The rates for adult and pediatric cases, respectively, were: respiratory complications 13.4 versus 9.1%, swallowing complications 12.1 versus 4.5%, neurologic complications 8.5 versus 9.1%, and cervical fusion rates 73.3 versus 86.4%. Across eight studies qualifying for meta-analysis, there were no differences in cervical fusion (odds ratio [OR]: 0.5, 95% confidence interval [CI]: [0.1, 2.1]), respiratory complications (OR: 3.5, 95% CI: [0.8, 14.5]), or swallowing complications (OR: 3.5, 95% CI: [0.5, 26.0]); however, pediatric patients had a higher rate of neurologic complications (OR: 5.2, 95% CI: [1.1, 25.0]). \u0000Conclusion In EO, rates of aerodigestive complications and cervical fusion are similar in both populations. There may be an increased risk of neurologic complications in pediatric patients, although more high-quality studies are needed. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0