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Posterior Fossa Dimensions of Chiari Malformation Patients Compared with Normal Subjects: Systematic Review and Meta-Analysis.
World Neurosurg. 2020 06; 138:521-529.e2.WN

Abstract

BACKGROUND

Chiari malformation (CM) is defined as a herniation of cerebellar tonsils below the foramen magnum and is considered to be due to underdevelopment of posterior fossa (PF) bone components. There is overcrowding of neural structures, and normal cerebrospinal fluid circulation is frequently blocked. Although several publications exist of measurements of dimensions and volumes from bone components of PF in CM, there is no systematic review evaluating quantitatively these dimensions. The aim of this study was to evaluate PF dimensions and volumes in a meta-analysis.

METHODS

An electronic search using PubMed and Google Scholar was done. Study eligibility criteria were defined by the PICO strategy, which selected patients and interventions. Studies comparing PF dimensions between patients with CM and normal subjects were selected. A meta-analysis of pooled data was done using statistical software.

RESULTS

Data for pooled analysis were obtained from 12 studies. Data synthesis was based on small published sample sizes in the majority of studies. Key findings included smaller measurements of clivus, supraoccipital bone, and PF area dimensions in patients with CM compared with normal subjects. Brainstem and cerebellar length was not different between groups.

CONCLUSIONS

This review provides evidence of smaller measurements of clivus, supraoccipital bone, and PF area dimensions in patients with CM compared with normal subjects. An implication of the key findings is that surgical treatment of CMs should consider the smaller dimensions of PF in planning.

Authors+Show Affiliations

Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil. Electronic address: bitbot@uol.com.br.Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil.Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, São Paulo, Brazil.Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil.Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32156591

Citation

Botelho, Ricardo Vieira, et al. "Posterior Fossa Dimensions of Chiari Malformation Patients Compared With Normal Subjects: Systematic Review and Meta-Analysis." World Neurosurgery, vol. 138, 2020, pp. 521-529.e2.
Botelho RV, Heringer LC, Botelho PB, et al. Posterior Fossa Dimensions of Chiari Malformation Patients Compared with Normal Subjects: Systematic Review and Meta-Analysis. World Neurosurg. 2020;138:521-529.e2.
Botelho, R. V., Heringer, L. C., Botelho, P. B., Lopes, R. A., & Waisberg, J. (2020). Posterior Fossa Dimensions of Chiari Malformation Patients Compared with Normal Subjects: Systematic Review and Meta-Analysis. World Neurosurgery, 138, 521-e2. https://doi.org/10.1016/j.wneu.2020.02.182
Botelho RV, et al. Posterior Fossa Dimensions of Chiari Malformation Patients Compared With Normal Subjects: Systematic Review and Meta-Analysis. World Neurosurg. 2020;138:521-529.e2. PubMed PMID: 32156591.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior Fossa Dimensions of Chiari Malformation Patients Compared with Normal Subjects: Systematic Review and Meta-Analysis. AU - Botelho,Ricardo Vieira, AU - Heringer,Lindolfo Carlos, AU - Botelho,Pedro B, AU - Lopes,Rosimary Amorim, AU - Waisberg,Jaques, Y1 - 2020/03/07/ PY - 2020/01/22/received PY - 2020/02/28/revised PY - 2020/02/29/accepted PY - 2020/3/12/pubmed PY - 2020/8/22/medline PY - 2020/3/12/entrez KW - Arnold-Chiari malformation KW - Basilar impression KW - Craniometry KW - Meta-Analysis SP - 521 EP - 529.e2 JF - World neurosurgery JO - World Neurosurg VL - 138 N2 - BACKGROUND: Chiari malformation (CM) is defined as a herniation of cerebellar tonsils below the foramen magnum and is considered to be due to underdevelopment of posterior fossa (PF) bone components. There is overcrowding of neural structures, and normal cerebrospinal fluid circulation is frequently blocked. Although several publications exist of measurements of dimensions and volumes from bone components of PF in CM, there is no systematic review evaluating quantitatively these dimensions. The aim of this study was to evaluate PF dimensions and volumes in a meta-analysis. METHODS: An electronic search using PubMed and Google Scholar was done. Study eligibility criteria were defined by the PICO strategy, which selected patients and interventions. Studies comparing PF dimensions between patients with CM and normal subjects were selected. A meta-analysis of pooled data was done using statistical software. RESULTS: Data for pooled analysis were obtained from 12 studies. Data synthesis was based on small published sample sizes in the majority of studies. Key findings included smaller measurements of clivus, supraoccipital bone, and PF area dimensions in patients with CM compared with normal subjects. Brainstem and cerebellar length was not different between groups. CONCLUSIONS: This review provides evidence of smaller measurements of clivus, supraoccipital bone, and PF area dimensions in patients with CM compared with normal subjects. An implication of the key findings is that surgical treatment of CMs should consider the smaller dimensions of PF in planning. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/32156591/Posterior_Fossa_Dimensions_of_Chiari_Malformation_Patients_Compared_with_Normal_Subjects:_Systematic_Review_and_Meta_Analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(20)30469-1 DB - PRIME DP - Unbound Medicine ER -