ArticleNeurosurgery2023
International Tuberculum Sellae Meningioma Study: Preoperative Grading Scale to Predict Outcomes and Propensity-Matched Outcomes by Endonasal Versus Transcranial Approach.
Article in Neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Revisiting traditional transcranial approaches for anterior skull base meningiomas: a systematic review and meta-analysis of transcranial approaches against minimally invasive surgical techniques.Neurosurgical review · 2025Pooled it
- From data to practice: brain meningioma treatment in elderly patients - a survey of the Italian Society of Neurosurgery (SINch®) and systematic review and meta-analysis.Neurosurgical review · 2024Pooled it
- Visual outcomes following endoscopic endonasal approach for tuberculum sellae meningiomas a systematic review and meta-analysis.International journal of surgery (London, England) · 2026Article
- A concise history of skull base surgery: what is its contribution to neurosurgery?Acta neurochirurgica · 2026Review
- Use of three-dimensional-printed models for preoperative planning in endoscopic endonasal surgery for tuberculum sellae meningioma: A case report and literature review.Surgical neurology international · 2026Article
- Endoscopic transnasal "microsurgery" for suprasellar meningioma involving the anterior communicating artery complex.Neurosurgical focus: Video · 2026Article
- Endoscopic endonasal approach for a tuberculum sellae meningioma with optic canal involvement.Neurosurgical focus: Video · 2026Article
- Prospective analysis of 30-day postoperative adverse events in skull base surgery: insights into risk factors and mitigation strategies from a neurosurgical tertiary care center.Neurosurgical review · 2025Article
- Supraorbital keyhole approach (SOKHA) versus endoscopic endonasal approach (EEA) for suprasellar meningioma (SSM) resection: systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2025Review
- 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
- Surgical treatment of tuberculum sellae meningioma: A retrospective review of single institutional experience.Surgical neurology international · 2024Article
- Endonasal Route for Tuberculum and Planum Meningiomas.Advances and technical standards in neurosurgery · 2024Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
BACKGROUND AND
objectivesTuberculum sellae meningiomas are resected via an expanded endonasal (EEA) or transcranial approach (TCA). Which approach provides superior outcomes is debated. The Magill-McDermott (M-M) grading scale evaluating tumor size, optic canal invasion, and arterial involvement remains to be validated for outcome prediction. The objective of this study was to validate the M-M scale for predicting visual outcome, extent of resection (EOR), and recurrence, and to use propensity matching by M-M scale to determine whether visual outcome, EOR, or recurrence differ between EEA and TCA.
methodsForty-site retrospective study of 947 patients undergoing tuberculum sellae meningiomas resection. Standard statistical methods and propensity matching were used.
resultsThe M-M scale predicted visual worsening (odds ratio [OR]/point: 1.22, 95% CI: 1.02-1.46, P = .0271) and gross total resection (GTR) (OR/point: 0.71, 95% CI: 0.62-0.81, P < .0001), but not recurrence ( P = .4695). The scale was simplified and validated in an independent cohort for predicting visual worsening (OR/point: 2.34, 95% CI: 1.33-4.14, P = .0032) and GTR (OR/point: 0.73, 95% CI: 0.57-0.93, P = .0127), but not recurrence ( P = .2572). In propensity-matched samples, there was no difference in visual worsening ( P = .8757) or recurrence ( P = .5678) between TCA and EEA, but GTR was more likely with TCA (OR: 1.49, 95% CI: 1.02-2.18, P = .0409). Matched patients with preoperative visual deficits who had an EEA were more likely to have visual improvement than those undergoing TCA (72.9% vs 58.4%, P = .0010) with equal rates of visual worsening (EEA 8.0% vs TCA 8.6%, P = .8018).
conclusionThe refined M-M scale predicts visual worsening and EOR preoperatively. Preoperative visual deficits are more likely to improve after EEA; however, individual tumor features must be considered during nuanced approach selection by experienced neurosurgeons.
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