Clinical Outcomes of Infratentorial Meningioma Surgery in a Developing Country

Citation:
Elkady, A., M. A. R. Soliman, and A. M. Ali, Clinical Outcomes of Infratentorial Meningioma Surgery in a Developing Country, , vol. 137, pp. e373 - e382, 2020.

Abstract:

BackgroundNo data are available on incidence, surgical approaches, complications, and survival for patients with infratentorial meningiomas in developing countries. Predictors for surgical resection, recurrence, and complications were analyzed based on the surgical outcomes of patients with infratentorial meningiomas.
Methods
A total of 101 consecutive cases of infratentorial meningiomas operated on between April 2012 and April 2017 at our institute were reviewed retrospectively. The patients had a mean age of 55.1 ± 5 years, a female predominance of 62.3%, and the mean duration of follow-up duration was 44.2 ± 15.5 months.
Results
The most common surgical approach was retrosigmoid (n = 51) followed by suboccipital (n = 36), subtemporal (n = 8), and far lateral (n = 6). The preoperative presentation showed that affected cranial nerve was the most common presenting symptom (47.5%) followed by weakness (24.8%) and affected vision (16.8%) followed by headache (8.9%) and gait disturbance (6.9%). The extent of resection was grade I (n = 63), grade II (n = 15)and grade III (n = 23) according to the Simpson grading. The complication rate was 56 cases (55.4%); the most common complication was cranial nerve palsy (42.6%), followed by weakness (31.7%), hydrocephalus (16.8%), chest infection (8.9%), ataxia (4%), deep venous thrombosis (4%), cerebrospinal fluid leak (3%) and meningitis and pulmonary embolism (both 1%).
Conclusions
The location, surgical approach, preoperative Karnofsky Performance Status, and peritumor edema were significantly associated with complications. Compared with developed countries, we had a higher complication rate (P < 0.001), lower recurrence rate (P = 0.15), and slightly lower total resection rate (P = 0.29). These findings might be attributed to the patient's late presentation to the tertiary center and poor technical resources.

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