Audiovestibular symptoms and facial nerve function comparing microsurgery versus SRS for vestibular schwannomas: a systematic review and meta-analysis.
Acta Neurochir (Wien)
; 164(12): 3221-3233, 2022 12.
Article
en En
| MEDLINE
| ID: mdl-35962847
ABSTRACT
OBJECTIVE:
Surgery and radiosurgery represent the most common treatment options for vestibular schwannoma. A systematic review and meta-analysis were conducted to compare the outcomes of surgery versus stereotactic radiosurgery (SRS).METHODS:
The Cochrane library, PubMed, Embase, and clinicaltrials.gov were searched through 01/2021 to find all studies on surgical and stereotactic procedures performed to treat vestibular schwannoma. Using a random-effects model, pooled odds ratios (OR) and their 95% confidence intervals (CI) comparing post- to pre-intervention were derived for pre-post studies, and pooled incidence of adverse events post-intervention were calculated for case series and stratified by intervention type.RESULTS:
Twenty-one studies (18 pre-post design; three case series) with 987 patients were included in the final analysis. Comparing post- to pre-intervention, both surgery (OR 3.52, 95%CI 2.13, 5.81) and SRS (OR 3.30, 95%CI 1.39, 7.80) resulted in greater odds of hearing loss, lower odds of dizziness (surgery OR 0.10; 95%CI 0.02, 0.47 vs. SRS OR 0.22; 95%CI 0.05, 0.99), and tinnitus (surgery OR 0.23; 95%CI 0.00, 37.9; two studies vs. SRS OR 0.11; 95%CI 0.01, 1.07; one study). Pooled incidence of facial symmetry loss was larger post-surgery (14.3%, 95%CI 6.8%, 22.7%) than post-SRS (7%, 95%CI 1%, 36%). Tumor control was larger in the surgery (94%, 95%CI 83%, 98%) than the SRS group (80%, 95%CI 31%, 97%) for small-to-medium size tumors.CONCLUSION:
Both surgery and SRS resulted in similar odds of hearing loss and similar improvements in dizziness and tinnitus among patients with vestibular schwannoma; however, facial symmetry loss appeared higher post-surgery.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Acúfeno
/
Neuroma Acústico
/
Radiocirugia
/
Pérdida Auditiva
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Acta Neurochir (Wien)
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos