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Long-Term Hearing Outcome For Vestibular Schwannomas After Microsurgery And Radiotherapy: A Systematic Review and Meta-Analysis
聽力長期結果前庭神經鞘瘤微手術和放射治療:系統綜述和統合分析

Antonio Daloiso, MD* © , Diego Cazzador, MD* © , Stefano Concheri, MD © , Giulia Tealdo, MD © , and Elisabetta Zanoletti, MD ©
安東尼奧·達羅伊索, MD* © , 迭戈·卡薩多, MD* © , 斯特凡諾·孔切里, MD © , 朱麗婭·特爾多, MD © , 以及伊麗莎白·薩諾萊蒂, MD ©

Abstract  摘要

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.
目標。聽力喪失是與前庭神經鞘瘤(VS)相關的常見症狀,或因腫瘤對蜗神經的影響,或因手術或立體定向放射手術(SRS)等主動治療。VS 的治療決策基於包括腫瘤大小、聽力狀態、患者症狀和機構偏好等因素。該研究旨在調查接受聽力保護治療的 VS 患者的長期聽力結果。

Data Sources. 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.
數據來源。進行了一項系統性文獻綜述,遵循首選報告項目系統評審和元分析指南,搜索 Scopus、Pubmed 和 Web of Science 數據庫,時間範圍從最初到 2024 年 1 月。

Review 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 Nonrandomized Studies of Interventions tool.
手術方法研究。符合納入標準的研究,包括至少 5 年的追蹤和治療前後聽力結果評估,均被納入。使用 MetaXL 軟體計算 SRS 手術和顯微手術後可用聽力的匯總盛行率估計。使用非隨機干預研究偏倚風險評估工具進行偏倚風險評估。

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 % 18.1 % 18.1%18.1 \% ( 95 % 95 % 95%95 \% confidence interval [CI]: I.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 % 74.5 % 74.5%74.5 \% ( 95 % Cl 95 % Cl 95%Cl95 \% \mathrm{Cl} : 63.5 % 84.1 % 63.5 % 84.1 % 63.5%-84.1%63.5 \%-84.1 \%