Complications in the Endoscopic Transorbital Approach for the Management of Spheno-Orbital Meningiomas: A Systematic Review and Meta-analysis

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, and 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 3,520 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: 0–18%). The pooled analysis also confirmed a 10% transitory visual deficit rate (CI: 0–24%).

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.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
07 February 2025