Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base section
Introduction: Orbital cavernous malformations (OCMs) are benign vascular lesions frequently associated with progressive proptosis and visual disturbances due to their slow growth and compression of adjacent structures. Multiple surgical approaches have been developed for their treatment, including m...
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2025-01-01
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| author | Edoardo Agosti Vittorio Ricciuti Giorgio Mantovani Giorgia De Rosa Pier Paolo Panciani Marco Maria Fontanella Cesare Zoia Moncef Berhouma Michaël Bruneau Luigi Maria Cavallo Jan Frederick Cornelius Sebastien Froelich Emmanuel Jouanneau Diego Mazzatenta Torstein R. Meling Mahmoud Messerer Dimitris Paraskevopoulos Pierre-Hugues Roche HenryWS. Schroeder Marcos Tatagiba Idoya Zazpe Roy Thomas Daniel |
| author_facet | Edoardo Agosti Vittorio Ricciuti Giorgio Mantovani Giorgia De Rosa Pier Paolo Panciani Marco Maria Fontanella Cesare Zoia Moncef Berhouma Michaël Bruneau Luigi Maria Cavallo Jan Frederick Cornelius Sebastien Froelich Emmanuel Jouanneau Diego Mazzatenta Torstein R. Meling Mahmoud Messerer Dimitris Paraskevopoulos Pierre-Hugues Roche HenryWS. Schroeder Marcos Tatagiba Idoya Zazpe Roy Thomas Daniel |
| author_sort | Edoardo Agosti |
| collection | DOAJ |
| description | Introduction: Orbital cavernous malformations (OCMs) are benign vascular lesions frequently associated with progressive proptosis and visual disturbances due to their slow growth and compression of adjacent structures. Multiple surgical approaches have been developed for their treatment, including microsurgical transfacial-transorbital approaches (MTTAs), cranio-orbital approaches (MCOAs), orbitotomies (MOs), endoscopic endonasal approaches (EEAs), and endoscopic transorbital approaches (ETOAs). However, the optimal approach remains a topic of debate. Research objective: This systematic review aims to compare the resection rates, postoperative complications, and clinical outcomes across various surgical approaches for OCM management. Methods: A comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library according to PRISMA guidelines. Studies reporting surgical treatment of OCMs with clinical outcome data were included. Study quality was assessed using the Newcastle-Ottawa Scale. Statistical analyses were conducted using chi-square and Mann-Whitney U tests. Results and conclusions: Of 239 screened studies, 94 met inclusion criteria, comprising 1007 patients (mean age 43.9 years; 58.5 % female). Proptosis (63.2 %) and visual impairment (48.1 %) were the most common symptoms. Most lesions were intraconal (80 %) and laterally positioned (42.8 %). EEAs were the most commonly used approach (40.1 %), followed by MOs (25.7 %) and MTTAs (21.6 %). Gross total resection was achieved in 93.7 % of cases. Complications were infrequent: visual acuity worsening (3.9 %), diplopia (2.4 %), and enophthalmos (1.7 %). Functional outcomes improved significantly, particularly visual acuity (65.1 %) and proptosis (61.6 %). EEAs provide high resection rates with minimal morbidity, especially for medial OCMs. ETOAs represent a promising, minimally invasive option for laterally located lesions. |
| format | Article |
| id | doaj-art-9ee52fb9dfad4beda2773c744a1ba90f |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Brain and Spine |
| spelling | doaj-art-9ee52fb9dfad4beda2773c744a1ba90f2025-08-20T03:26:52ZengElsevierBrain and Spine2772-52942025-01-01510430210.1016/j.bas.2025.104302Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base sectionEdoardo Agosti0Vittorio Ricciuti1Giorgio Mantovani2Giorgia De Rosa3Pier Paolo Panciani4Marco Maria Fontanella5Cesare Zoia6Moncef Berhouma7Michaël Bruneau8Luigi Maria Cavallo9Jan Frederick Cornelius10Sebastien Froelich11Emmanuel Jouanneau12Diego Mazzatenta13Torstein R. Meling14Mahmoud Messerer15Dimitris Paraskevopoulos16Pierre-Hugues Roche17HenryWS. Schroeder18Marcos Tatagiba19Idoya Zazpe20Roy Thomas Daniel21Department of Medical and Surgical Specialties, Division of Neurosurgery, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, ItalySchool of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, ItalyDepartment of Translational Medicine, University of Ferrara, Ferrara, Italy; Neurosurgery Department, S. Anna University Hospital of Ferrara, Ferrara, ItalyDepartment of Medical and Surgical Specialties, Division of Neurosurgery, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, ItalyDepartment of Medical and Surgical Specialties, Division of Neurosurgery, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, ItalyDepartment of Medical and Surgical Specialties, Division of Neurosurgery, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, ItalyNeurosurgical Unit, Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy; Corresponding author. Via Pelascini 3, Gravedona e Uniti, 22015, Como, Italy.Department of Neurosurgery, University Hospital of Dijon Bourgogne, Dijon, FranceDepartment of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, BelgiumDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, ItalyDepartment of Neurosurgery, Medical Faculty & University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, GermanyDepartment of Neurosurgery, Hopital Lariboisiere, Paris, FranceDepartment of Skull Base and Pituitary Surgery, Pituitary Tumors Centers of Excellence (PTCOE) of Lyon, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, FranceDepartment of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy; Programma Neurochirurgia Ipofisi - Pituitary Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, ItalyNeurosurgery, Copenhagen University Hospital, Rigshospitalet, DenmarkDepartment of Neurosurgery, University Hospital of Lausanne and University of Lausanne, Lausanne, SwitzerlandDepartment of Neurosurgery, Barts Health NHS Trust, The Royal London Hospital, London, United KingdomDepartment of Neurosurgery, Hôpital Nord, APHM, Marseille, FranceDepartment of Neurosurgery, University Medicine Greifswald, Greifswald, GermanyDepartment of Neurosurgery and Neurotechnology, Eberhard Karls University, Tübingen, GermanyDepartment of Neurosurgery, University Hospital of Navarre, Pamplona, SpainDepartment of Neurosurgery, University Hospital of Lausanne and University of Lausanne, Lausanne, SwitzerlandIntroduction: Orbital cavernous malformations (OCMs) are benign vascular lesions frequently associated with progressive proptosis and visual disturbances due to their slow growth and compression of adjacent structures. Multiple surgical approaches have been developed for their treatment, including microsurgical transfacial-transorbital approaches (MTTAs), cranio-orbital approaches (MCOAs), orbitotomies (MOs), endoscopic endonasal approaches (EEAs), and endoscopic transorbital approaches (ETOAs). However, the optimal approach remains a topic of debate. Research objective: This systematic review aims to compare the resection rates, postoperative complications, and clinical outcomes across various surgical approaches for OCM management. Methods: A comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library according to PRISMA guidelines. Studies reporting surgical treatment of OCMs with clinical outcome data were included. Study quality was assessed using the Newcastle-Ottawa Scale. Statistical analyses were conducted using chi-square and Mann-Whitney U tests. Results and conclusions: Of 239 screened studies, 94 met inclusion criteria, comprising 1007 patients (mean age 43.9 years; 58.5 % female). Proptosis (63.2 %) and visual impairment (48.1 %) were the most common symptoms. Most lesions were intraconal (80 %) and laterally positioned (42.8 %). EEAs were the most commonly used approach (40.1 %), followed by MOs (25.7 %) and MTTAs (21.6 %). Gross total resection was achieved in 93.7 % of cases. Complications were infrequent: visual acuity worsening (3.9 %), diplopia (2.4 %), and enophthalmos (1.7 %). Functional outcomes improved significantly, particularly visual acuity (65.1 %) and proptosis (61.6 %). EEAs provide high resection rates with minimal morbidity, especially for medial OCMs. ETOAs represent a promising, minimally invasive option for laterally located lesions.http://www.sciencedirect.com/science/article/pii/S2772529425001213Cavernous malformationsOrbitSystematic reviewSurgical approachesOutcomes |
| spellingShingle | Edoardo Agosti Vittorio Ricciuti Giorgio Mantovani Giorgia De Rosa Pier Paolo Panciani Marco Maria Fontanella Cesare Zoia Moncef Berhouma Michaël Bruneau Luigi Maria Cavallo Jan Frederick Cornelius Sebastien Froelich Emmanuel Jouanneau Diego Mazzatenta Torstein R. Meling Mahmoud Messerer Dimitris Paraskevopoulos Pierre-Hugues Roche HenryWS. Schroeder Marcos Tatagiba Idoya Zazpe Roy Thomas Daniel Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base section Brain and Spine Cavernous malformations Orbit Systematic review Surgical approaches Outcomes |
| title | Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base section |
| title_full | Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base section |
| title_fullStr | Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base section |
| title_full_unstemmed | Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base section |
| title_short | Surgical management and postoperative outcomes of orbital cavernous malformations: A systematic literature review by the EANS skull base section |
| title_sort | surgical management and postoperative outcomes of orbital cavernous malformations a systematic literature review by the eans skull base section |
| topic | Cavernous malformations Orbit Systematic review Surgical approaches Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425001213 |
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