{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:40:56Z","timestamp":1790970056788,"version":"4.1.0"},"reference-count":53,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>In microvascular decompression (MVD) surgery through the retrosigmoid approach, the surgeon may have to sacrifice the superior petrosal vein (SPV). However, this is a controversial maneuver. To date, high-level evidence comparing the operative outcomes of patients who underwent MVD with and without SPV sacrifice is lacking. Therefore, this study sought to bridge this gap.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors searched the Medline and PubMed databases with appropriate Medical Subject Heading (MeSH) terms and keywords. The primary outcome was vascular-related complications; secondary outcomes were new neurological deficit, cerebrospinal fluid (CSF) leak, and neuralgia relief. The pooled proportions of outcomes and OR (95% CI) for categorical data were calculated by using the logit transformation and Mantel-Haenszel methods, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Six studies yielding 1143 patients were included, of which 618 patients had their SPV sacrificed. The pooled proportion (95% CI) values were 3.82 (0.87\u201315.17) for vascular-related complications, 3.64 (1.0\u201312.42) for new neurological deficits, 2.85 (1.21\u20136.58) for CSF leaks, and 88.90 (84.90\u201391.94) for neuralgia relief. The meta-analysis concluded that, whether the surgeon sacrificed or preserved the SPV, the odds were similar for vascular-related complications (2.5% vs 1.5%, OR [95% CI] 1.01 [0.33\u20133.09], p<jats:italic> =<\/jats:italic> 0.99), new neurological deficits (1.2% vs 2.8%, OR [95% CI] 0.55 [0.18\u20131.66], p<jats:italic> =<\/jats:italic> 0.29), CSF leak (3.1% vs 2.1%, OR [95% CI] 1.16 [0.46\u20132.94], p<jats:italic> =<\/jats:italic> 0.75), and neuralgia relief (86.6% vs 87%, OR [95% CI] 0.96 [0.62\u20131.49], p<jats:italic> =<\/jats:italic> 0.84).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>SPV sacrifice is as safe as SPV preservation. The authors recommend intentional SPV sacrifice when gentle retraction fails to enhance surgical field visualization and if the surgeon encounters SPV-related neurovascular conflict and\/or anticipates impeding SPV-related bleeding.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.5.jns22143","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T19:36:25Z","timestamp":1657308985000},"page":"390-398","source":"Crossref","is-referenced-by-count":15,"title":["Sacrifice or preserve the superior petrosal vein in microvascular decompression surgery: a systematic review and meta-analysis"],"prefix":"10.3171","volume":"138","author":[{"given":"Shahab Aldin","family":"Sattari","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ataollah","family":"Shahbandi","sequence":"additional","affiliation":[{"name":"Tehran School of Medicine, Tehran University of Medical Science, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risheng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Feghali","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuyang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetan","family":"Bettegowda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Technique of microvascular decompression","volume":"18","author":"Jannetta PJ","year":"2005","unstructured":"Jannetta PJ, McLaughlin MR, Casey KF. 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