Abstract：
OBJECTIVE: Hearing loss is a common symptom associated with vestibular schwannoma (VS), either because of the tumor\'s effects on the cochlear nerve or due to active treatments such as surgery or stereotactic radiosurgery (SRS). Treatment decisions for VS are based on factors including tumor size, hearing status, patient symptoms, and institutional preference. The study aimed to investigate long-term auditory outcomes in VS patients undergoing active treatments with a hearing preservation intent.
METHODS: A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching Scopus, Pubmed, and Web of Science databases from inception to January 2024.
METHODS: Studies meeting inclusion criteria, including a minimum 5-year follow-up and assessment of pre- and posttreatment hearing outcomes, were included. Pooled prevalence estimates for serviceable hearing after SRS and microsurgery were calculated using MetaXL software. Risk of bias assessment was performed with the Risk of Bias in Non-randomized Studies of Interventions tool.
RESULTS: Nine studies met the inclusion criteria, with 356 patients included for analysis. The pooled prevalence of maintaining serviceable hearing after SRS at 10 years was 18.1% (95% confidence interval [CI]: 1.7%-43.3%), with wide prediction intervals indicating variability in outcomes. Microsurgery demonstrated a higher prevalence of maintaining long-term serviceable hearing, with a pooled estimate of 74.5% (95% CI: 63.5%-84.1%).
CONCLUSIONS: This systematic review underscores the importance of long-term follow-up in evaluating auditory outcomes in VS treatment. Despite the biases inherent to pretreatment patients selection, hearing preservation microsurgery for sporadic VS removal demonstrated favorable and stable long-term serviceable hearing.
METHODS: A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching Scopus, Pubmed, and Web of Science databases from inception to January 2024.
METHODS: Studies meeting inclusion criteria, including a minimum 5-year follow-up and assessment of pre- and posttreatment hearing outcomes, were included. Pooled prevalence estimates for serviceable hearing after SRS and microsurgery were calculated using MetaXL software. Risk of bias assessment was performed with the Risk of Bias in Non-randomized Studies of Interventions tool.
RESULTS: Nine studies met the inclusion criteria, with 356 patients included for analysis. The pooled prevalence of maintaining serviceable hearing after SRS at 10 years was 18.1% (95% confidence interval [CI]: 1.7%-43.3%), with wide prediction intervals indicating variability in outcomes. Microsurgery demonstrated a higher prevalence of maintaining long-term serviceable hearing, with a pooled estimate of 74.5% (95% CI: 63.5%-84.1%).
CONCLUSIONS: This systematic review underscores the importance of long-term follow-up in evaluating auditory outcomes in VS treatment. Despite the biases inherent to pretreatment patients selection, hearing preservation microsurgery for sporadic VS removal demonstrated favorable and stable long-term serviceable hearing.
摘要：
目的：听力损失是与前庭神经鞘瘤（VS）相关的常见症状，要么是由于肿瘤对耳蜗神经的影响，要么是由于手术或立体定向放射外科（SRS）等积极治疗。VS的治疗决策基于包括肿瘤大小在内的因素，听力状态,患者症状,和制度偏好。该研究旨在调查VS患者的长期听觉结果，这些患者正在接受具有听力保护意图的积极治疗。
方法：根据系统评价和荟萃分析指南的首选报告项目进行了系统文献综述，搜索Scopus,Pubmed,和WebofScience数据库从成立到2024年1月。
方法：符合纳入标准的研究，包括至少5年的随访和评估治疗前后的听力结果，包括在内。使用MetaXL软件计算SRS和显微手术后可用听力的集合患病率估计值。使用非随机干预研究工具中的偏倚风险进行偏倚风险评估。
结果：九项研究符合纳入标准，356名患者纳入分析。SRS后10年维持可用听力的合并患病率为18.1％（95％置信区间[CI]：1.7％-43.3％），较宽的预测区间表明结果的可变性。显微外科手术表明，保持长期可用的听力的患病率更高，合并估计值为74.5%（95%CI：63.5%-84.1%）。
结论：本系统综述强调了长期随访在VS治疗中评估听觉结果的重要性。尽管预处理患者选择固有的偏见，用于散发性VS切除的听力保留显微外科手术显示出良好且稳定的长期可用听力。
方法：根据系统评价和荟萃分析指南的首选报告项目进行了系统文献综述，搜索Scopus,Pubmed,和WebofScience数据库从成立到2024年1月。
方法：符合纳入标准的研究，包括至少5年的随访和评估治疗前后的听力结果，包括在内。使用MetaXL软件计算SRS和显微手术后可用听力的集合患病率估计值。使用非随机干预研究工具中的偏倚风险进行偏倚风险评估。
结果：九项研究符合纳入标准，356名患者纳入分析。SRS后10年维持可用听力的合并患病率为18.1％（95％置信区间[CI]：1.7％-43.3％），较宽的预测区间表明结果的可变性。显微外科手术表明，保持长期可用的听力的患病率更高，合并估计值为74.5%（95%CI：63.5%-84.1%）。
结论：本系统综述强调了长期随访在VS治疗中评估听觉结果的重要性。尽管预处理患者选择固有的偏见，用于散发性VS切除的听力保留显微外科手术显示出良好且稳定的长期可用听力。
