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Abstract：
Background Evidence on hearing outcome measures when assessing hearing preservation following stereotactic radiosurgery (SRS) for adults with vestibular schwannoma (VS) has not previously been collated in a structured review. Objective The objective of the present study was to perform a scoping review of the evidence regarding the choice of hearing outcomes and other methodological characteristics following SRS for adults with VS. Methods The protocol was registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses extension guidelines for scoping reviews. A systematic search of five online databases revealed 1,591 studies, 247 of which met the inclusion criteria. Results The majority of studies ( n = 213, 86%) were retrospective cohort or case series with the remainder ( n = 34, 14%) prospective cohort. Pure-tone audiometry and speech intelligibility were included in 222 (90%) and 158 (64%) studies, respectively, often summarized within a classification scheme and lacking procedural details. Fifty-nine (24%) studies included self-report measures. The median duration of follow-up, when reported, was 43 months (interquartile range: 29, 4-150). Conclusion Evidence on hearing disability after SRS for VS is based on low-quality studies which are inherently susceptible to bias. This review has highlighted an urgent need for a randomized controlled trial assessing hearing outcomes in patients with VS managed with radiosurgery or radiological observation. Similarly, consensus and coproduction of a core outcome set to determine relevant hearing and communication outcome domains is required. This will ensure that patient priorities, including communication abilities in the presence of background noise and reduced participation restrictions, are addressed.
摘要：
背景技术对于患有前庭神经鞘瘤（VS）的成年人进行立体定向放射外科手术（SRS）后评估听力保留时，听力结果指标的证据尚未在结构化审查中得到整理。目的本研究的目的是对VS成人SRS后听力结果和其他方法学特征的选择进行范围审查。方法该方案在国际注册系统评价和荟萃分析方案平台（INPLASY）注册，并根据系统评价和荟萃分析首选报告项目扩展指南进行范围审查。对五个在线数据库的系统搜索显示了1591项研究，其中247项符合纳入标准。结果大多数研究（n=213，86％）为回顾性队列或病例系列，其余（n=34，14％）为前瞻性队列。纯音测听和言语清晰度被纳入222（90％）和158（64％）研究，分别,经常在分类方案中总结，缺乏程序细节。59项（24％）研究包括自我报告措施。中位随访时间，当报告时，为43个月（四分位数范围：29，4-150）。结论VSSRS后听力障碍的证据是基于低质量的研究，这些研究固有地易受偏倚的影响。这篇评论强调了迫切需要一项随机对照试验，以评估接受放射外科或放射学观察的VS患者的听力结果。同样，需要达成共识并共同产生核心结果集，以确定相关的听力和交流结果域。这将确保患者优先考虑，包括在存在背景噪音和减少参与限制的情况下的沟通能力，已解决。
