A clinical study of ocular motor nerve functions after petroclival meningioma resection

Wang, Liang; Zhang, Qing; Weng, Jian-Cong; Chen, Liangpeng; Li, Da; Jia, Guijun; Zhang, Liwei; Wu, Zhen; Jia, Wang; Zhang, Junting

doi:10.1007/s00701-020-04262-4

Cited by 5 publications

(7 citation statements)

References 17 publications

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confidence: 99%

“…Few studies have analyzed the preoperative prognostic factors for ANP (14,16). These studies have reported risk factors including whether the tumor exceeded the midline, whether the infratrigeminal area was exposed, and whether adhesion between the tumor and nerves persisted (14). However, previous investigations of various bone structures and radiologic parameters observed in MRI have been insufficient, and the number of patients enrolled in these studies was very small; thus, the application of statistical analysis in these studies was limited.…”

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confidence: 99%

“…Because the abducens nerve has a long intracranial portion, it is easily damaged by a subtle injury mechanism involving stretching during PCM surgery (13). This injury consequently limits the abduction function of the patient's eye, causing strabismus and diplopia (14). Reports indicate that some anatomical sites are more prone to these injuries, and the risk may vary depending on the histology of the tumor (15).…”

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confidence: 99%

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Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Yoo¹,

Lim²,

Jung³

et al. 2021

Journal of Neuro-Ophthalmology

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Background:During the surgical resection of petroclival meningiomas, preserving the cranial nerves is crucial. The abducens nerve is particularly vulnerable during surgery. However, the preoperative risk factors and postoperative prognosis of abducens nerve palsy (ANP) are poorly understood.Methods:We retrospectively analyzed 70 patients who underwent surgery for petroclival meningiomas between May 2010 and December 2019, divided into gross-total resection (GTR) and subtotal resection (STR) groups. The relationship of preoperative clinical factors with the incidence and recovery of postoperative ANP was analyzed.Results:Postoperative ANP was observed in 23 patients (32.9%). Multivariable logistic regression revealed that the tumor-to-cerebellar peduncle T2 imaging intensity index (TCTI) (P < 0.001) and internal auditory canal invasion (P = 0.033) contributed to postoperative ANP. GTR was achieved in 37 patients (52.9%), and 10 (27.0%) of them showed ANP. STR was achieved in 33 patients (47.1%), and 13 (39.4%) of them showed ANP. Recovery from ANP took a median of 6.6 months (range, 4.5–20.3 months). At 6 months after the operation, recovery of the abducens nerve function was observed in 16 patients (69.0%); of whom, 4 (40.0%) were in the GTR group and 12 (92.3%) were in the STR group (P = 0.025).Conclusions:TCTI and internal auditory canal invasion were the risk factors for postoperative ANP. Although intentional STR did not prevent ANP immediately after the operation, recovery of the abducens nerve function after surgery was observed more frequently in the STR group than in the GTR group.

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confidence: 99%

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confidence: 99%

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Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Yoo¹,

Lim²,

Jung³

et al. 2021

Journal of Neuro-Ophthalmology

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“…There is a high variety in the literature regarding the rate of new abducens nerve deficits following PC MNG surgery. The incidence in the literature ranges from relatively low rates at 5–8% to higher rates at 38.7% [ 11 , 12 , 13 , 14 ]. The incidence of new-onset abducens nerve palsy in the present investigation was 21.9% and ranks amongst the midfield regarding abducens nerve deficits compared to the reported rates.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the achievements of modern neurosurgery with the pursuit of a maximum of safety, surgical morbidities including cranial nerve deficits remain a tremendous complication resulting in further medical interventions and decreased quality of life [ 9 , 10 ]. Abducens nerve palsy is a frequently observed nerve dysfunction, and previous series reported incidences of new-onset palsies after surgery in up to 38.7% of patients [ 11 , 12 , 13 , 14 ]…”

Section: Introductionmentioning

confidence: 99%

Increased MIB-1 Labeling Index Is Associated with Abducens Nerve Morbidity in Primary Sporadic Petroclival Meningioma Surgery: Beyond Location and Approach

et al. 2022

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Abducens nerve palsy is a severe dysfunction after petroclival meningioma (PC MNG) surgery. The objective of this investigation was to analyze abducens nerve outcomes in patients who underwent the retrosigmoid approach in relation to the MIB-1 index. Thirty-two patients with primary sporadic PC MNG were retrospectively analyzed. Mean follow-up was 28.0 months. Analysis of the MIB-1 index was performed to evaluate the abducens nerve outcome. An optimal MIB-1 index cut-off value (<4/≥4) in the association with postoperative CN VI palsy was determined by ROC analysis (AUC: 0.74, 95% CI: 0.57–0.92). A new-onset CN VI palsy was present in 7 cases (21.88%) and was significantly associated with an increased MIB-1 index (≥4%, p = 0.025) and a peritumoral edema in the brachium pontis (p = 0.047) which might be caused by the increased growth rate. Tumor volume, cavernous sinus infiltration, auditory canal invasion, and Simpson grading were not associated with new CN VI deficits. Six (85.7%) of the 7 patients with both an increased MIB-1 index (≥4%) and new abducens nerve palsy still had a CN VI deficit at the 12-month follow-up. A peritumoral edema caused by a highly proliferative PC MNG with an elevated MIB-1 index (≥4%) is associated with postoperative abducens nerve deficits.

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Postoperative trigeminal neuropathy outcomes following surgery for tumors involving the trigeminal nerve

Chen

et al. 2023

Acta Neurochir

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A clinical study of ocular motor nerve functions after petroclival meningioma resection

Cited by 5 publications

References 17 publications

Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Increased MIB-1 Labeling Index Is Associated with Abducens Nerve Morbidity in Primary Sporadic Petroclival Meningioma Surgery: Beyond Location and Approach

Postoperative trigeminal neuropathy outcomes following surgery for tumors involving the trigeminal nerve

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