Abstract：
BACKGROUND: Vestibular schwannomas (VS) are benign tumors arising from vestibular nerve\'s Schwann cells. Surgical resection via retrosigmoid (RS) or middle fossa (MF) is standard, but the optimal approach remains debated. This meta-analysis evaluated RS and MF approaches for VS management, emphasizing hearing preservation and Cranial nerve seven (CN VII) outcomes stratified by tumor size.
METHODS: Systematic searches across PubMed, Cochrane, Web of Science, and Embase identified relevant studies. Hearing and CN VII outcomes were gauged using the American Academy of Otolaryngology-Head and Neck Surgery, Gardner Robertson, and House-Brackmann scores.
RESULTS: Among 7228 patients, 56 % underwent RS and 44 % MF. For intracanalicular tumors, MF recorded 38 % hearing loss, compared to RS\'s 54 %. In small tumors (<1.5 cm), MF showed 41 % hearing loss, contrasting RS\'s lower 15 %. Medium-sized tumors (1.5 cm-2.9 cm) revealed 68 % hearing loss in MF and 55 % in RS. Large tumors (>3cm) were only reported in RS with a hearing loss rate of 62 %.
CONCLUSIONS: Conclusively, while MF may be preferable for intracanalicular tumors, RS demonstrated superior hearing preservation for small to medium-sized tumors. This research underlines the significance of stratified outcomes by tumor size, guiding surgical decisions and enhancing patient outcomes.
METHODS: Systematic searches across PubMed, Cochrane, Web of Science, and Embase identified relevant studies. Hearing and CN VII outcomes were gauged using the American Academy of Otolaryngology-Head and Neck Surgery, Gardner Robertson, and House-Brackmann scores.
RESULTS: Among 7228 patients, 56 % underwent RS and 44 % MF. For intracanalicular tumors, MF recorded 38 % hearing loss, compared to RS\'s 54 %. In small tumors (<1.5 cm), MF showed 41 % hearing loss, contrasting RS\'s lower 15 %. Medium-sized tumors (1.5 cm-2.9 cm) revealed 68 % hearing loss in MF and 55 % in RS. Large tumors (>3cm) were only reported in RS with a hearing loss rate of 62 %.
CONCLUSIONS: Conclusively, while MF may be preferable for intracanalicular tumors, RS demonstrated superior hearing preservation for small to medium-sized tumors. This research underlines the significance of stratified outcomes by tumor size, guiding surgical decisions and enhancing patient outcomes.
摘要：
背景：前庭神经鞘瘤（VS）是由前庭神经的雪旺细胞引起的良性肿瘤。手术切除通过乙状窦后（RS）或中窝（MF）是标准的，但最佳方法仍存在争议。这项荟萃分析评估了RS和MF方法的VS管理，强调听力保留和颅神经七（CNVII）结局按肿瘤大小分层。
方法：整个PubMed的系统搜索，科克伦,WebofScience,Embase确定了相关研究。听力和CNVII结果使用美国耳鼻咽喉头颈外科学会进行测量。加德纳·罗伯逊,和House-Brackmann得分.
结果：在7228名患者中，56％接受RS和44％MF。对于囊内肿瘤，MF记录了38%的听力损失，与RS的54%相比。在小肿瘤（<1.5厘米），MF显示41%的听力损失，相比之下，RS较低15%。中型肿瘤（1.5cm-2.9cm）在MF中显示68％的听力损失，在RS中显示55％的听力损失。仅在RS中报告了大肿瘤（>3cm），听力损失率为62％。
结论：最后，而MF可能更适合于小管内肿瘤，RS对中小型肿瘤表现出优异的听力保护。这项研究强调了肿瘤大小分层结果的重要性，指导手术决策并提高患者预后。
方法：整个PubMed的系统搜索，科克伦,WebofScience,Embase确定了相关研究。听力和CNVII结果使用美国耳鼻咽喉头颈外科学会进行测量。加德纳·罗伯逊,和House-Brackmann得分.
结果：在7228名患者中，56％接受RS和44％MF。对于囊内肿瘤，MF记录了38%的听力损失，与RS的54%相比。在小肿瘤（<1.5厘米），MF显示41%的听力损失，相比之下，RS较低15%。中型肿瘤（1.5cm-2.9cm）在MF中显示68％的听力损失，在RS中显示55％的听力损失。仅在RS中报告了大肿瘤（>3cm），听力损失率为62％。
结论：最后，而MF可能更适合于小管内肿瘤，RS对中小型肿瘤表现出优异的听力保护。这项研究强调了肿瘤大小分层结果的重要性，指导手术决策并提高患者预后。
