Visual Outcomes after Expanded Endoscopic Endonasal Resection of Anterior Skull Base Meningiomas
Bibliographic record
Abstract
Background: The endoscopic endonasal approach has become increasingly utilized in the treatment of anterior skull base meningiomas. These tumors, in particularly planum and tuberculum meningiomas, often cause visual symptoms due to compression of the optic apparatus, and/or involvement of optic canal. We aimed to examine visual outcomes after endoscopic endonasal resection of anterior skull base meningiomas in patients who also underwent optic decompression, and to identify preoperative factors predictive of postoperative visual improvement. Methods: We performed a retrospective chart review on 21 patients who underwent endoscopic endonasal resection of anterior skull base meningiomas with optic nerve decompression between January 1, 2005, and September 1, 2018, at McMaster University. Results: The mean age of our patients was 57.6 years. This comprised 4 male and 17 female patients. Seventeen patients (80.9%) presented with visual symptoms. The mean duration of symptoms was 8.96 months. Gross-total resection was achieved in five patients (23.8%). Four additional patients (19%) underwent a second-stage transcranial surgery to achieve gross-total resection. Three other patients received radiation therapy. Bilateral decompression of optic apparatus was performed in 10 patients, and unilateral decompression was performed in 11 patients. Six patients (35.3%) had postoperative improvement of visual acuity of at least two lines on Snellen chart. Three patients had improvement of visual fields. Visual deterioration occurred in one patient (4.76%). On comparing preoperative symptom duration, less than 6 months of visual decline was more likely to be associated with postoperative improvement of visual acuity, with an odds ratio (OR) of 0.0625 (95% CI: 0.0043–0.915, p < 0.05). Tumor volume of less than 30 mL was not associated with better visual outcomes in our cohort (OR: 1.17; 95% CI: 0.133–10.22; p = 0.14). Conclusion: The endoscopic endonasal approach combined with optic nerve decompression can achieve good visual outcomes in patients with anterior skull base meningiomas. Symptom duration of less than 6 months is a positive predictor of postoperative visual acuity improvement.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".