Comparison of the Efficacy in Improving Trigeminal Neuralgia in Petroclival Meningioma between Microsurgery and Radiosurgery: A Meta-analysis

Introduction: 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).

Method: PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched from the inception until December 08, 2022.

Result: 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).

Conclusion: Based on the results of this meta-analysis, we can conclude that microsurgery is superior to radiosurgery as a treatment of PCM-related TN.

Publication History

Article published online:
05 February 2024