Abstract
Background: The current study aimed to investigate the predictive value of visual-evoked potential (VEP) latency for post-operative visual deterioration in patients undergoing craniopharyngioma resection via extended endoscopic endonasal approach (EEEA).Methods: Data from 90 patients who underwent craniopharyngioma resection via EEEA with intraoperative VEP monitoring were retrospectively reviewed. P100 latency was compared between patients with and without post-operative visual deterioration, and the threshold value of P100 latency for predicting post-operative visual deterioration was calculated by the receiver operating characteristic curve analysis. In addition, other potential prognostic factors regarding post-operative visual outcomes were also analyzed by multivariate analysis.Results: Patients with post-operative visual deterioration showed a significantly longer VEP latency than those without (p < 0.001). An extension over 8.61% in VEP latency was identified as a predictor of post-operative visual deterioration (p < 0.001). By contrast, longer preoperative visual impairment duration and larger tumor volume were not significant predictors for post-operative visual deterioration.Conclusions: The current study revealed that intraoperative VEP monitoring in EEEA is effective for predicting post-operative visual deterioration, and an extension over 8.61% in VEP latency can be used as a critical cut-off value to predict post-operative visual deterioration.
Highlights
The current study aimed to investigate the predictive value of visual-evoked potential (VEP) latency for post-operative visual deterioration in patients undergoing craniopharyngioma resection via extended endoscopic endonasal approach (EEEA)
We aimed to investigate the predictive value of P100 latency of VEP for postoperative visual deterioration in patients undergoing EEEA, and to attempt to calculate an appropriate threshold of P100 latency prolongation to avoid post-operative visual deterioration
Craniopharyngiomas of adamantinomatous type were histopathologically diagnosed in 48 cases (73.8%), whereas papillary type was identified in 17 cases (26.2%)
Summary
The current study aimed to investigate the predictive value of visual-evoked potential (VEP) latency for post-operative visual deterioration in patients undergoing craniopharyngioma resection via extended endoscopic endonasal approach (EEEA). Craniopharyngioma represents around 1.2–4.6% of all intracranial tumors. It is originated from the remnant of Rathke’s pouch and histologically benign (Grade I according to the 2016 World Health Organization Classification). VEP Monitoring in Craniopharyngiomas and chiasm, pituitary stalk, gland and hypothalamus, complete resection is usually difficult, and the risk of relevant postoperative complications is quite high [1, 2]. The EEEA could provide an improved visual field of the optic nerves and chiasm, and hypothalamus, injury of optic pathways is still the most common surgical complication [3–5]
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