Factores que influyen en el grado de resección y propuesta de escala preoperatoria para el manejo de meningiomas de base de cráneo

https://doi.org/10.59156/revista.v37i01.502

Abstract

Abstract:

Objectives: identify factors that intervene in the degree of resection of skull base meningiomas and propose a scale to calculate the probability of total resection.

Materials and methods: single-center, observational, retrospective study of patients operated in the period 06/2018 - 06/2022. The following variables were used: age, symptoms, location, size, previous embolization, perilesional edema, intratumoral calcium, characteristics in T2 and T1 and bone invasion. The degree of resection was measured using the traditional Simpson scale and was also divided into total (Simpson I, II, and III) and subtotal (Simpson IV and V) resection. With the results, a scale was proposed taking into account the variables with statistical significance (p < 0.05). A bibliographic review of the subject was carried out.

Results: A total of 23 patients were operated. They were statistically significant associated with Simpson's grade the location (p 0.002) and size (p 0.001). Associated with total and subtotal resection, the bone invasion (p 0.013). For the scale we use: location (anterior 1 point, posterior 2 points, medial 2 points and medial involving the cavernous sinus 3 points), size (<5 cm 1 point, >5 cm 2 points) and bone invasion (no 1 point and yes 2 points).  We performed an inferential analysis and an association was observed between the scale used and the degree of resection (p 0.005).

Conclusion: In our study, an association was observed between the size, location and bone invasion with the degree of resection achieved. We proposed a scale to measure the probability of total resection.

Keywords: meningioma, skull base, Simpson, scale, single-center study, statistic análisis.