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Long-term Hearing Preservation After Resection of Vestibular Schwannoma: A Systematic Review and Meta-analysis
- Source :
- Otologyneurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 38(10)
- Publication Year :
- 2017
-
Abstract
- The objective is to perform a systematic review and meta-analysis of the literature on the long-term results of hearing preservation after vestibular schwannoma resection.Ovid/Medline, PubMed, Embase, and the Cochrane library from January 1980 to January 2015.Inclusion criteria: age ≥18 years, minimum 10 patients in the treatment group, hearing preserving microsurgery, no previous radiation treatment, serviceable hearing at immediate postop follow-up, hearing outcomes reported using Gardner Robinson or the American Academy of Otolaryngology-Head and Neck Surgeons hearing grading scales, and average follow-up of 5 years. Preoperative, immediate postoperative, and last follow-up audiograms were required. Exclusion criteria included neurofibromatosis type 2 patients and surgery for salvage therapy or decompression.Quality evaluated using Methodological Index for Non-Randomized Studies.Meta-analysis was performed using R v3.2.2, Metafor package v 1.9-7. Cohen's D was used to determine effect size. Ten reports had at least 5-year follow-up and used standardized hearing grading scales. The systematic review found that if hearing was preserved at Class A or B at early postop visit, the chance of preserving hearing at 5 years was excellent. Those who maintained speech discrimination score ≥ 89% at the early postoperative follow-up had better long-term hearing preservation. The meta-analysis reveals that only preoperative and postoperative pure-tone average was associated with long-term hearing preservation.Long-term (5 yr) hearing durability rates are generally very good. Most studies do not report patient and tumor characteristics, therefore precluding combining studies for meta-analysis. Only preoperative and postoperative postoperative pure-tone average was associated with long-term hearing durability.
- Subjects :
- Adult
Male
medicine.medical_specialty
Treatment outcome
MEDLINE
Audiology
Schwannoma
Cochrane Library
Resection
03 medical and health sciences
0302 clinical medicine
Hearing
otorhinolaryngologic diseases
Medicine
Humans
Postoperative Period
030223 otorhinolaryngology
Vestibular system
Hearing preservation
business.industry
General surgery
Neuroma, Acoustic
Middle Aged
medicine.disease
Sensory Systems
Treatment Outcome
Otorhinolaryngology
Meta-analysis
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15374505
- Volume :
- 38
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Otologyneurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
- Accession number :
- edsair.doi.dedup.....3fa5b8b8a3100210c1b32bac5cdaed23