2025 Proffered Presentations
S226: COMPLICATIONS IN THE ENDOSCOPIC TRANSORBITAL APPROACH FOR THE MANAGEMENT OF SPHENO-ORBITAL MENINGIOMAS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Filipe V Ribeiro1; Lucca Palavani2; Marcelo P Porto Sousa3; Filipi F Andreão3; Márcio Ferreira4; Guilherme Garcia5; Ary Neto6; Laura Montecino7; Christian Fukunaga8; Helvécio Filho9; Allan Polverini10; Herika Brito11; 1Barão de Mauá, Faculty of Medicine; 2Max Planck University Center, Indaiatuba, São Paulo, Brazil; 3Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 4Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY, USA; 5Faculty of Medical Sciences, University of Pernambuco, Pernambuco, Brazil; 6College of Medicine Multivix, Cachoeiro de Itapemirim - ES, Brazil; 7Faculty of Medical Sciences, Metropolitan University of Barranquilla , Barranquilla, Colombia; 8Faculty of Medicine, FMABC University Center, São Paulo, Brazil; 9Federal University of Fortaleza, Ceara, Brazil; 10Neurosurgical Oncology division, Department of Neurosurgery, Barretos Cancer Hospital, Barretos, São Paulo; 11Department of Neurosurgery, Mayo Clinic Hospital, Arizona, United States
Introduction: Meningioma is the most common benign tumor in the central nervous system and may arise from the sphenoid wing region. The tumor can involve the cavernous sinus medially, periorbital and orbital apex structures anteriorly, and infratemporal fossa inferiorly. Surgical approaches currently available include the fronto-temporal approach, the pterional approach and even the frontotemporal-orbitozygomatic approach. The results of complications in the Transorbital neuroendoscopic surgery for these cases are still unclear, with scarce literature on the subject.
Objective: The objective of the present study is to evaluate the Complications in the Endoscopic Transorbital Approach for the Management of Spheno-Orbital Meningiomas.
Methods: We searched Medline, Embase, Web of Science databases following PRISMA guidelines. We used single proportion analysis with 95% confidence intervals under a random-effects model, I2 to assess heterogeneity, and Baujat and sensitivity analysis to address high heterogeneity. Eligible studies included those with ≥3 patients treated with endoscopic transorbital approach for the management of spheno-orbital meningioma.
Results: From 3520 initially identified studies, 11 were selected, involving 248 patients, with a median follow-up of 44 months. Regarding diplopia, the pooled analysis confirmed a 8% diplopia rate (CI: 0% to 18%). The pooled analysis also confirmed a 10% transitory visual deficit rate (CI: 0% to 24%).
Conclusion: Based on the results, our meta-analysis identified that transorbital endoscopic approach has been shown to be safe for the management of spheno-orbital meningioma, due to the low complications rate.
