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J Neurol Surg B Skull Base
DOI: 10.1055/s-0044-1779671
Original Article

Visual Outcomes after Suprasellar Meningioma Resection: A Retrospective Cohort Study and a Machine Learning-Based Predictive Model

Arad Iranmehr 
1   Department of Neurosurgery, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex (IKHC), Tehran, Iran
,
Mohammadreza Chavoshi
2   Department of Radiology, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
,
Mehdi Zeinalizadeh
1   Department of Neurosurgery, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex (IKHC), Tehran, Iran
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Abstract

Objectives In this research, the authors provide a retrospective cohort study of 82 patients with suprasellar meningiomas to identify predictors of the visual outcome following surgery. We also conducted a matched retrospective case–control analysis.

Methods This retrospective cohort study included all patients who underwent craniotomy for surgical excision of suprasellar meningiomas at our institution between January 2016 and March 2022. We designed a matched case–control study for patients with and without early intradural optic canal decompression (IOCD). We also developed a machine learning model to have the best possible sensitivity for the prediction of visual recovery after surgery.

Results The visual acuity score (VAS) improved in 46.3% of our cases and decreased in 7.4% of the 82 included cases postoperatively. The VAS did not change in 46.3% of the patients after surgery. Statistically, visual complaints, optic atrophy, tuberculum sella involvement, and olfactory groove involvement were associated with lower preoperative VAS and visual field index (VFI). Only intracavernous sinus (ICS) extension and intraoperative vascular involvement were significantly associated with lower postoperative mean VAS correction. The outcome analysis revealed that the improvement in VAS and VFI after surgery was not statistically different between the groups with and without early IOCD (p-value = 1).

Conclusion ICS extension was the only location-related factor associated with increased tumor recurrence or regrowth, which makes postoperative radiotherapy more valuable in patients with cavernous sinus extension. Our study results did not support the efficacy of early IOCD in increasing postoperative VAS and VFI.

Keywords

optic canal decompression - suprasellar - meningioma - visual outcome


Publication History

Received: 06 November 2023

Accepted: 10 January 2024

Article published online:
23 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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