Cavernous sinus haemangioma: systematic review and pooled analysis relating to a rare skull base pathology.

Autor: Osunronbi T; Department of Surgery, Hull University Teaching Hospital, Hull, UK.; Department of Health Sciences, University of York, York, UK., May Myat Noe Pwint P; Department of Surgery, Manchester University NHS Hospitals Foundation Trust, Manchester, UK., Usuah J; Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, PR2 9HT, Preston, UK., Cain J; Department of Radiology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, PR2 9HT, UK., Mathur S; Department of Radiology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, PR2 9HT, UK., Gurusinghe NT; Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, PR2 9HT, Preston, UK., Roberts GA; Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, PR2 9HT, Preston, UK., Alalade AF; Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, PR2 9HT, Preston, UK. andrew.alalade@nhs.net.
Jazyk: angličtina
Zdroj: Neurosurgical review [Neurosurg Rev] 2022 Aug; Vol. 45 (4), pp. 2583-2592. Date of Electronic Publication: 2022 Apr 25.
DOI: 10.1007/s10143-022-01796-2
Abstrakt: Cavernous sinus haemangiomas (CSHs) are rare malformations of the microcirculation arising from the cavernous sinus. A systematic review and pooled data analysis of the associated clinical features, diagnostic modalities, management, and outcomes for CSHs was done. In total, 68 articles (338 cases) were eligible for analysis based on our selection criteria. The primary outcome measures were the occurrence of (i) and (ii) symptom resolution/improvement. Categorical outcome variables were assessed by binary logistic regression at 5% significance level. With headaches (39.9%) and diplopia (36.5%) as the most common presenting symptoms reported, dynamic contrast-enhanced MRI was the most commonly used diagnostic modality and was the most definitive pre-treatment imaging modality for diagnosing CSH with a sensitivity of 89.5%. The majority of CSHs were managed with radiosurgery (47.9% of cases), 37.9% by surgical resection alone, and 14.2% by a combination of both. Compared to patients that were treated with surgical resection only, those treated solely with radiosurgery had a 100% decrease in the odds of developing post-treatment complications (adjusted OR: 0.00, 95% CI: 0.00-0.002, p < 0.001), with a 5.03 times greater odds of symptom resolution/improvement (adjusted OR: 5.03, 95% CI: 1.89-13.4, p = 0.001). Patients that underwent combined therapy had a 79% reduction in risk of developing post-treatment complications (adjusted OR: 0.21, 95% CI: 0.06-0.68, p = 0.01), with no statistically significant difference in the odds of symptom resolution/improvement, compared to those that had surgery only. In conclusion, radiosurgery offered the best outcomes with regards to symptom resolution/improvement and post-treatment complications in patients with CSH.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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