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S117: ADVANCING EVIDENCE QUALITY AND REPRODUCIBILITY IN ENDOSCOPIC TRANSORBITAL APPROACH IN NEUROSURGERY RESEARCH: A SYSTEMATIC REVIEW AND REPORTING GUIDELINE FOR ENHANCED COMPARABILITY
Rudolfh Batista Arend¹; Bruno Zilli Peroni, MS¹; Daniel Marchi Kieling, MS¹; Pedro Henrique Ieggli, MS¹; Victor Luiz Ferreira Kauer, MS¹; Henrique Padilha Gnoatto, MS¹; Daniel Felipe Savaris, MS¹; Filipe Virgilio Ribeiro, MS²; Raphael Bertani, MD³; Alex Roman, MsC, MD⁴; Martin Batista Coutinho da Silva, MD⁵; Pierre-Olivier Champagne, MD⁶; Guilherme Gago, MD⁵; ¹Federal University of Fronteira Sul, Passo Fundo, RS, Brazil; ²Barão de Mauá Faculty of Medicine, Ribeirão Preto, SP, Braz; ³Hospital Israelita Albert Einstein, SP, Brazil; ⁴Institute of Neurosurgery and Spine Surgery (INCC), Passo Fundo, RS, Brazil; ⁵University of Passo Fundo, Passo Fundo, Brazil; ⁶Université Laval, Quebec, Canada

Objective: To evaluate the quality of studies reporting clinical and surgical outcomes of meningiomas and trigeminal schwannomas treated with the endoscopic transorbital approach (ETOA), and to develop a Reporting Guideline to enhance reproducibility and comparability. 

Methods: We systematically searched on PubMed, Embase, Scopus, and Web of Science up to July 2025. We included studies reporting patients with meningiomas or trigeminal schwannomas that were treated with ETOA; we excluded case series with <5 patients, and secondary evidence (systematic reviews/meta-analyses, conference abstracts, case reports). Reporting quality was assessed across nine domains: (1) patient baseline characteristics; (2) imaging methods and tumor features; (3) definitions of pivotal concepts; (4) neurosurgical/interventional team characteristics; (5) anesthetic protocol; (6) surgical procedure details; (7) clinical and procedural outcomes, including adverse events; (8) retreatment details; and (9) funding and conflicts of interest. Additionally, baseline characteristics of the included studies were extracted to contextualize our analysis.

Results: Thirteen observational studies comprising 310 patients (82.1% meningiomas, 17.9% trigeminal schwannomas) were included. Critical appraisal revealed consistent shortcomings across all nine domains, highlighting major gaps in the current literature. The main gaps included the lack of reporting on previous comorbidities, tumor classification, clear definitions of postoperative complications, deficits, adverse effects, and mortality, as well as details regarding anesthetic protocols and perioperative events. Additional missing information involved the time from symptom onset to initial treatment, whether the procedure was elective or emergency, and the occurrence of intraoperative and postoperative complications – particularly hemorrhage, mortality, and its underlying causes. Based on these findings, we developed the Endoscopic Transorbital Approach Reporting Guideline, comprising 61 items across the nine domains, designed to standardize reporting of surgical and clinical outcomes. 

Conclusion: This systematic review of 13 studies on ETOA for meningiomas and trigeminal schwannomas revealed substantial methodological and reporting limitations, which undermine the reliability of current evidence and constrain the advancement of knowledge in this field. The proposed Reporting Guideline provides a structured framework to address these shortcomings and to improve transparency, reproducibility, and comparability in future research. By fostering standardized reporting, it has the potential to strengthen the evidence base, support the accumulation of robust knowledge, and ultimately enhance both clinical understanding and patient care in the management of these complex pathologies.

Figure 1: PRISMA Flow Diagram

 

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