Time-based Assessment of Hearing Preservation Rates After Microsurgical Resection of Vestibular Schwannomas: A Systematic Review.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
Anastasia A HuntSamuel P Gubbels

Abstract

To determine short- and intermediate-term hearing preservation rates after microsurgical resection of vestibular schwannoma (VS). Systematic review of the Ovid, Cochrane, EMBASE, and Web of Science databases. This study was restricted to full-text English-language articles detailing VS resection via the middle cranial fossa or retrosigmoid approaches. Documentation of pre- and posttreatment hearing outcomes with American Academy of Otolaryngology-Head and Neck Surgery, Gardner-Robertson, or word recognition score scales, as well as time to follow-up were required. Duplicate data sets, studies with >10% of patients with neurofibromatosis two, previous or nonsurgical VS treatment, case reports with <five patients, or studies detailing decompressive surgery were excluded. Two authors independently performed full-text reviews to determine study eligibility. Discrepancies were settled by consensus. "Class A/B, I/II" hearing was defined as AAO-HNS Class A or B, Gardner-Robertson Class 1 or 2, or PTA ≤ 50 dB with word recognition score ≥ 50% on audiogram. Pooled estimates of preserved Class A/B, I/II hearing at last postoperative follow-up. Of 1323 reports, 14 were utilized in analyses yielding data from 2,977 patients. Mean follow-up...Continue Reading

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