Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-Ro, Guro-Gu, Seoul, 08308, Korea.
Neurosurg Rev. 2023 Nov 28;46(1):314. doi: 10.1007/s10143-023-02225-8.
The purpose of this study was to systematically review studies in the literature to assess the superiority between microsurgery and radiosurgery regarding the efficacy in improving petroclival meningioma (PCM)-related trigeminal neuralgia (TN). PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched from the inception until December 08, 2022. The overall proportion of patients with improved TN after treatment in all six included studies was 56% (95% confidence interval [CI], 35-76.9%). Higgins I statistics showed significant heterogeneity (I = 90%). Subgroup analysis showed that the proportion of improved TN was higher in the microsurgery group than that in the radiosurgery group (89%; 95% CI, 81-96.5% vs. 37%, 95% CI, 22-52.7%, respectively, p < 0.01). Subgroup analysis (for studies that documented the number of posttreatment Barrow Neurological Institute scores 1 and 2) revealed that the proportion of pain-free without medication after treatment was higher in the microsurgery group than that in the radiosurgery group (90.7%; 95% CI, 81-99.7% vs. 34.5%, 95% CI, 21.3-47.7.7%, respectively, p < 0.01). Based on the results of this meta-analysis, we concluded that microsurgery is superior to radiosurgery in controlling PCM-related TN.
本研究的目的是系统地回顾文献中的研究，以评估显微手术和放射外科在改善岩斜脑膜瘤（PCM）相关三叉神经痛（TN）方面的疗效优势。从研究开始到 2022 年 12 月 8 日，我们系统地检索了 PubMed、Embase、Web of Science 和 Cochrane 临床试验数据库。所有纳入的 6 项研究中，治疗后 TN 改善的患者总体比例为 56%（95%置信区间，35-76.9%）。Higgins I 统计显示存在显著异质性（I=90%）。亚组分析显示，显微手术组 TN 改善的比例高于放射外科组（89%，95%置信区间，81-96.5% vs. 37%，95%置信区间，22-52.7%，p<0.01）。亚组分析（针对记录了治疗后巴罗神经研究所评分 1 和 2 号的研究）显示，治疗后无药物治疗的无痛比例在显微手术组高于放射外科组（90.7%，95%置信区间，81-99.7% vs. 34.5%，95%置信区间，21.3-47.7.7%，p<0.01）。基于这项荟萃分析的结果，我们得出结论，显微手术在控制 PCM 相关 TN 方面优于放射外科。
