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Meta-analysis on the clinical outcomes in patients with intralabyrinthine schwannomas: conservative management vs. microsurgery
- Source :
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 273(6)
- Publication Year :
- 2014
-
Abstract
- The objective of this review is to compare the symptomatological evolution following conservative management (CM) or microsurgery (MS) in patients with intralabyrinthine schwannomas (ILS). A thorough systematic review of the English and French literature from 1948 to February 2014 was performed using Ovid Medline. An ancestor search was also completed. The major inclusion criterion consisted of a diagnosis of ILS with magnetic resonance imaging. Patients with a classic vestibular schwannoma, cases of incidentaloma during surgery or an autopsy were the main exclusion criteria. Thirty-one studies met our selective criteria. Descriptive data were collected from the articles. Clinical outcomes regarding the hearing loss, tinnitus, vertigo, dizziness and aural fullness were stated as improved, unchanged or worse at the last follow-up. All data were then separated into two different groups according to the management option: CM and MS. The data were analyzed using a Pearson χ (2) test and Fisher's exact test. This meta-analysis suggests that MS has a statistically significant favorable outcome regarding symptom relief compared to CM in patients with ILS suffering from tinnitus, vertigo and dizziness. Hearing level was not compared between treatment groups, as MS leads to anacusis. An indicative bias was the main limitation of this study, as patients suffering from intractable vertigo with moderate-to-severe hearing loss were referred to MS. Therefore, in the presence of a serviceable hearing, we suggest that CM should be the treatment of choice.
- Subjects :
- Adult
Male
medicine.medical_specialty
Microsurgery
Hearing loss
Deafness
Conservative Treatment
Dizziness
03 medical and health sciences
Tinnitus
0302 clinical medicine
Vertigo
otorhinolaryngologic diseases
medicine
Humans
030223 otorhinolaryngology
Hearing Loss
Ear Neoplasms
Aged
Aged, 80 and over
biology
business.industry
Incidentaloma
General Medicine
Middle Aged
biology.organism_classification
Magnetic Resonance Imaging
Surgery
Exact test
Otorhinolaryngology
Hearing level
Meta-analysis
Ear, Inner
Female
medicine.symptom
business
030217 neurology & neurosurgery
Neurilemmoma
Subjects
Details
- ISSN :
- 14344726
- Volume :
- 273
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
- Accession number :
- edsair.doi.dedup.....dbe44923eaa2729ad4189d1569bc8e37