SynthesisActa neurochirurgica2021
Trends in cerebrospinal fluid leak rates following the extended endoscopic endonasal approach for anterior skull base meningioma: a meta-analysis over the last 20 years.
Synthesis in Acta neurochirurgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Pooled it
- Efficiency and safety of optic canal unroofing in tuberculum sellae meningiomas: a meta-analysis and systematic review.Neurosurgical review · 2023Pooled it
- Skull base repair following endonasal pituitary and skull base tumour resection: a systematic review.Pituitary · 2021Pooled it
- Risk factors for postoperative cerebrospinal fluid leak following endoscopic transsphenoidal surgery for craniopharyngioma: a multicenter cohort study with a contemporary surgeon practice survey.Journal of neuro-oncology · 2026Article
- Risk Factors for Postoperative Cerebrospinal Fluid Leak Following Endoscopic Transsphenoidal Surgery for Craniopharyngioma: A Multicenter Cohort Study with a Contemporary Surgeon Practice Survey.Research square · 2026Article
- Midterm Outcomes of the Endoscopic Endonasal Approach for Treating Tuberculum Sellae Meningiomas: The Impact of Malleable Forceps and Predictors of Surgical Success.Journal of neurological surgery. Part B, Skull base · 2026Article
- Review
- Dural suturing for the resolution of high-flow cerebrospinal fluid leakage after extended endoscopic endonasal approach surgery.Neurosurgical review · 2025Article
- Real-time intraoperative ultrasound imaging of the posterior pituitary gland during endoscopic endonasal approach.Acta neurochirurgica · 2024Article
- Safety and efficacy of hydroset cranioplasty as an adjunct to gasket-seal and nasoseptal flap closure of the skull base. A case-controlled study.Acta neurochirurgica · 2024Article
- A novel multilayered membrane repair technique for high-flow cerebrospinal fluid leaks during expanded endoscopic endonasal tumor resection.American journal of translational research · 2024Article
- Clinical study on the selection of endoscopes and microscopes for transsphenoidal surgery of non-aggressive pituitary macroadenoma and microadenoma and the influencing factors of hyposmia after endoscopic transsphenoidal surgery.Frontiers in neurology · 2024Article
- Monitoring of visual-evoked potentials during fat packing in endoscopic resection of a giant pituitary adenoma.Surgical neurology international · 2024Article
- The impact of obesity on rates of post-operative CSF leak following endoscopic skull base surgery: results from a prospective international multi-centre cohort study.Frontiers in endocrinology · 2024Article
- Review
- International Tuberculum Sellae Meningioma Study: Surgical Outcomes and Management Trends.Neurosurgery · 2023Article
- Effects of Endoscopic Sinus Surgery on Olfactory Function.Current allergy and asthma reports · 2023Review
- Risk Factors for Postoperative Cerebrospinal Fluid Leak after Graded Multilayer Cranial Base Repair with Suturing via the Endoscopic Endonasal Approach.Neurologia medico-chirurgica · 2023Article
- Machine learning driven prediction of cerebrospinal fluid rhinorrhoea following endonasal skull base surgery: A multicentre prospective observational study.Frontiers in oncology · 2023Article
- Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe extended endoscopic approach provides unimpaired visualization and direct access to ventral skull base pathology, but is associated with cerebrospinal fluid (CSF) leak in up to 25% of patients. To evaluate the impact of improved surgical techniques and devices to better repair skull base defects, we assessed published surgical outcomes of the extended endoscopic endonasal approach in the last two decades for a well-defined homogenous group of tuberculum sellae and olfactory groove meningioma patients.
methodsRandom-effects meta-analyses were performed for studies published between 2004 (first publications) and April 2020. We evaluated CSF leak as primary outcome. Secondary outcomes were gross total resection, improvement in visual outcomes in those presenting with a deficit, intraoperative arterial injury, and 30-day mortality. For the main analyses, publications were pragmatically grouped based on publication year in three categories: 2004-2010, 2011-2015, and 2016-2020.
resultsWe included 29 studies describing 540 patients with tuberculum sellae and 115 with olfactory groove meningioma. The percentage patients with CSF leak dropped over time from 22% (95% CI: 6-43%) in studies published between 2004 and 2010, to 16% (95% CI: 11-23%) between 2011 and 2015, and 4% (95% CI: 1-9%) between 2016 and 2020. Outcomes of gross total resection, visual improvement, intraoperative arterial injury, and 30-day mortality remained stable over time
conclusionsWe report a noticeable decrease in CSF leak over time, which might be attributed to the development and improvement of new closure techniques (e.g., Hadad-Bassagasteguy flap, and gasket seal), refined multilayer repair protocols, and lumbar drain usage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.