Haydn Hoffman, Brendan B. Maloney, Dan Y. Draytsel, Harish Babu
{"title":"颈静脉孔束瘤手术切除后的疗效：系统性回顾和 Meta 分析","authors":"Haydn Hoffman, Brendan B. Maloney, Dan Y. Draytsel, Harish Babu","doi":"10.1055/a-2215-6209","DOIUrl":null,"url":null,"abstract":"<p>\n<b>Objectives</b> We sought to perform a systematic review and meta-analysis of outcomes after surgical resection of jugular foramen schwannomas (JFSs).</p> <p>\n<b>Design</b> A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p> <p>\n<b>Setting</b> PubMed, Scopus, and Embase databases were searched.</p> <p>\n<b>Participants</b> Case series of at least five patients undergoing surgical resection of JFSs were included.</p> <p>\n<b>Main Outcome Measures</b> Primary outcomes included gross total resection (GTR) and near total resection (NTR) rates, as well as a composite of the two (GTR + NTR). Additional outcomes included new or worsening cranial nerve (CN) palsies and cerebrospinal fluid (CSF) leak. Random effects models were used to generate pooled outcomes.</p> <p>\n<b>Results</b> A total of 25 studies comprising 567 patients were included in the study. The proportions of each tumor grade were the following: grade A (33.1%), grade B (16.1%), grade C (9.2%), and grade D (41.6%). The pooled rate of GTR was 81% (95% confidence interval [CI]: 70–88; <i>I</i>\n<sup>2</sup> = 78.9%) and the composite GTR + NTR rate was 88% (95% CI: 81–93; <i>I</i>\n<sup>2</sup> = 66.4%). Rates of new or worsening CN palsies were the following: 12% hearing loss (95% CI: 7–20; <i>I</i>\n<sup>2</sup> = 69.4%), 27% dysphagia (95% CI: 20–36; <i>I</i>\n<sup>2</sup> = 66%), 20% hoarseness (95% CI: 14–28; <i>I</i>\n<sup>2</sup> = 62.6%), and 19% facial palsy (95% CI: 13–28; <i>I</i>\n<sup>2</sup> = 64.6%). The pooled rate of CSF leak was 9% (95% CI: 6–15; <i>I</i>\n<sup>2</sup> = 43.9%).</p> <p>\n<b>Conclusion</b> The literature suggests high GTR rates of JFSs can be achieved. However, new CN deficits are not uncommon.</p> ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"6 1","pages":""},"PeriodicalIF":0.9000,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes after Surgical Resection of Jugular Foramen Schwannomas: Systematic Review and Meta-Analysis\",\"authors\":\"Haydn Hoffman, Brendan B. Maloney, Dan Y. Draytsel, Harish Babu\",\"doi\":\"10.1055/a-2215-6209\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>\\n<b>Objectives</b> We sought to perform a systematic review and meta-analysis of outcomes after surgical resection of jugular foramen schwannomas (JFSs).</p> <p>\\n<b>Design</b> A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p> <p>\\n<b>Setting</b> PubMed, Scopus, and Embase databases were searched.</p> <p>\\n<b>Participants</b> Case series of at least five patients undergoing surgical resection of JFSs were included.</p> <p>\\n<b>Main Outcome Measures</b> Primary outcomes included gross total resection (GTR) and near total resection (NTR) rates, as well as a composite of the two (GTR + NTR). Additional outcomes included new or worsening cranial nerve (CN) palsies and cerebrospinal fluid (CSF) leak. Random effects models were used to generate pooled outcomes.</p> <p>\\n<b>Results</b> A total of 25 studies comprising 567 patients were included in the study. The proportions of each tumor grade were the following: grade A (33.1%), grade B (16.1%), grade C (9.2%), and grade D (41.6%). The pooled rate of GTR was 81% (95% confidence interval [CI]: 70–88; <i>I</i>\\n<sup>2</sup> = 78.9%) and the composite GTR + NTR rate was 88% (95% CI: 81–93; <i>I</i>\\n<sup>2</sup> = 66.4%). Rates of new or worsening CN palsies were the following: 12% hearing loss (95% CI: 7–20; <i>I</i>\\n<sup>2</sup> = 69.4%), 27% dysphagia (95% CI: 20–36; <i>I</i>\\n<sup>2</sup> = 66%), 20% hoarseness (95% CI: 14–28; <i>I</i>\\n<sup>2</sup> = 62.6%), and 19% facial palsy (95% CI: 13–28; <i>I</i>\\n<sup>2</sup> = 64.6%). The pooled rate of CSF leak was 9% (95% CI: 6–15; <i>I</i>\\n<sup>2</sup> = 43.9%).</p> <p>\\n<b>Conclusion</b> The literature suggests high GTR rates of JFSs can be achieved. 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Outcomes after Surgical Resection of Jugular Foramen Schwannomas: Systematic Review and Meta-Analysis
Objectives We sought to perform a systematic review and meta-analysis of outcomes after surgical resection of jugular foramen schwannomas (JFSs).
Design A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Setting PubMed, Scopus, and Embase databases were searched.
Participants Case series of at least five patients undergoing surgical resection of JFSs were included.
Main Outcome Measures Primary outcomes included gross total resection (GTR) and near total resection (NTR) rates, as well as a composite of the two (GTR + NTR). Additional outcomes included new or worsening cranial nerve (CN) palsies and cerebrospinal fluid (CSF) leak. Random effects models were used to generate pooled outcomes.
Results A total of 25 studies comprising 567 patients were included in the study. The proportions of each tumor grade were the following: grade A (33.1%), grade B (16.1%), grade C (9.2%), and grade D (41.6%). The pooled rate of GTR was 81% (95% confidence interval [CI]: 70–88; I2 = 78.9%) and the composite GTR + NTR rate was 88% (95% CI: 81–93; I2 = 66.4%). Rates of new or worsening CN palsies were the following: 12% hearing loss (95% CI: 7–20; I2 = 69.4%), 27% dysphagia (95% CI: 20–36; I2 = 66%), 20% hoarseness (95% CI: 14–28; I2 = 62.6%), and 19% facial palsy (95% CI: 13–28; I2 = 64.6%). The pooled rate of CSF leak was 9% (95% CI: 6–15; I2 = 43.9%).
Conclusion The literature suggests high GTR rates of JFSs can be achieved. However, new CN deficits are not uncommon.
期刊介绍：
The Journal of Neurological Surgery Part B: Skull Base (JNLS B) is a major publication from the world''s leading publisher in neurosurgery. JNLS B currently serves as the official organ of several national and international neurosurgery and skull base societies.
JNLS B is a peer-reviewed journal publishing original research, review articles, and technical notes covering all aspects of neurological surgery. The focus of JNLS B includes microsurgery as well as the latest minimally invasive techniques, such as stereotactic-guided surgery, endoscopy, and endovascular procedures. JNLS B is devoted to the techniques and procedures of skull base surgery.
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