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Long-term Hearing Preservation After Resection of a Vestibular Schwannoma: A Systematic Review and Meta-analysis

Ahsan SF1, Huq F, Seidman M, Taylor A.

PubMed.gov
U.S. National Library of Medicine, National Institutes of Health

Objective

The objective is to perform a systematic review and meta-analysis which is a quantitative study design used to systematically assess the results of the literature on the long-term results of hearing preservation after vestibular schwannoma resection.

Study Selection

Inclusion criteria: age ≥18 years, minimum 10 patients in the treatment group, hearing preserving microsurgery, no previous radiation treatment, serviceable hearing at immediate postop follow-up, hearing outcomes reported using Gardner Robinson or the American Academy of Otolaryngology-Head and Neck Surgeons hearing grading scales, and average follow-up of 5 years. Preoperative, immediate postoperative, and last follow-up audiograms were required. Exclusion criteria included neurofibromatosis type 2 patients and surgery for salvage therapy or decompression.

Data Synthesis

The systematic review found that if hearing was preserved at Class A or B at early postop visit, the chance of preserving hearing at 5 years was excellent. Those who maintained speech discrimination score ≥ 89% at the early postoperative follow-up had better long-term hearing preservation. The meta-analysis reveals that only preoperative and postoperative pure-tone average was associated with long-term hearing preservation.

Conclusion

Long-term (>5 yr) hearing durability rates are generally very good. Most studies do not report patient and tumor characteristics, therefore precluding combining studies for meta-analysis. Only preoperative and postoperative pure-tone average was associated with long-term hearing durability.

 


 

Otol Neurotol. 2017 Dec;38(10):1505-1511. doi: 10.1097/MAO.0000000000001560.