Loading prediction engine

Connecting to prediction server...

0s, cold boot

About the tuberculum sella meningioma models

Two questions drive surgery for tuberculum sellae meningioma: how much tumor to remove, and through which corridor. The surgical trade-off view scores six plans (partial, subtotal or gross-total resection, each through an open transcranial or endoscopic endonasal approach) on re-operation, recurrence and four groups of harm: vision, nerve or carotid injury; diabetes insipidus or hypopituitarism; CSF leak or meningitis; and brain retraction injury or hematoma.

Plans are compared with game theory (Nash and Kalai-Smorodinsky bargaining between tumor control and safety), and a robust plan is reported from 30 re-fitted models. A second view predicts the probability of visual improvement after surgery.

Predicts: Re-operation, recurrence and complication risk for six surgical plans; probability of post-operative visual improvement.
Inputs: Age, BMI, sex, tumor diameter, pre-op vision, prior surgery, planum and sellar or suprasellar extension. The visual model also uses specific visual symptoms, anatomic regions involved, hydrocephalus, endocrine status, intraoperative CSF leak and the approach performed.
Outputs: Recommended plan, bargaining frontier, payoff matrix, robust plan, and per-plan risks with confidence intervals.
Approaches compared: Open transcranial and endoscopic endonasal; bifrontal, frontal, orbitopterional and pterional in the visual model.

Key terms

Research demonstration only. Not for clinical decision-making.