SynthesisActa neurochirurgica2025
Update on anterior clinoid process removal in anterior clinoid meningioma surgery: literature review, and a new didactical concept.
Synthesis in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Vascular-based compartmental resection of anterior clinoidal meningiomas: an inter-perforator microdebulking strategy.Acta neurochirurgica · 2026Article
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2 authors.
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Abstract
purposeAnterior clinoidal meningioma (ACM) remains a challenging lesion to treat surgically due to its intricate neurovascular relationships with surrounding anatomy and often presents with ipsilateral visual loss. Anterior clinoidectomy (AC) by skilled skull base surgeons enables early optic nerve (ON) decompression, tumor devascularization, and radical tumor resection. The authors provide an update on ACM surgery, current views on the role of AC and its impact on outcomes in surgical treatment, as well as a new 2 stage 4 by 4 step concept of ON decompression involving AC.
methodsA systematic review of PubMed and meta-regression of surgically treated ACMs was performed.
resultsIn total, 908 patients were analyzed; 415 (45.7%) underwent routine AC (performed in all cases) and 493 (54.3%) underwent selective AC (planned preoperatively). The routine AC cohort showed higher risk for new cranial-nerve (CN) deficits (12.5% vs. 3.0%; p < 0.001), vascular complications (6.7% vs. 3.3%; p = 0.02), and new focal neurological deficits (5.5% vs. 2.3%; p = 0.04). No differences were found in visual outcomes, gross-total resection, mortality, recurrence, or other major complications. Random-effects meta-regression of routine AC showed increased odds of new CN deficit (odds ratio [OR], 3.34; 95% confidence interval [95% CI], 1.51-7.38; p = 0.005; heterogeneity [I
conclusionsIn experienced hands, AC remains an invaluable tool for ACM treatment as it offers more consistent tumor devascularization, prevention of tumor recurrence, optic nerve decompression, and increased working space, which facilitates optimal tumor resection and better long-term control and functional outcome. We propose a new didactical structured concept of routine AC via 2-stage, 4 by 4 steps to improve the utility of AC and decrease associated operative risks compared to selective AC.
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