HOUT-13. POSTOPERATIVE HEARING PRESERVATION IN PATIENTS UNDERGOING RETROSIGMOID CRANIOTOMY FOR RESECTION OF VESTIBULAR SCHWANNOMAS: A META-ANALYSIS OF 1, 249 PATIENTS. (5th November 2018)

• Record Type: Journal Article
• Authors: Udawatta, Methma; Ong, Vera; Sheppard, John; Duong, Courtney; Nguyen, Thien; Kwan, Isabelle; Preet, Komal; Gopen, Quinton; Yang, Isaac
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi115
• Page End: vi116
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.481
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND: Vestibular schwannomas (VS) are slow-growing, benign tumors originating from over-proliferation of Schwann cells ensheathing the vestibulocochlear nerve. Sensorineuronal hearing loss is the most common presenting symptom. RESEARCH QUESTION: To investigate estimated hearing preservation (HP) rates in VS patients after retrosigmoid (RS) surgery through a meta-analysis based on published hearing outcomes. METHODS: PubMed and Cochrane were used to identify applicable retrospective and prospective studies. Study heterogeneity was quantified through t2, Q, and I2 statistics. A Wald-type Q statistic was used to assess statistical significance of study heterogeneity. Assessment of study bias was performed using standard funnel plot analysis and an Eggers test for funnel plot asymmetry. RESULTS: Significant cross-study heterogeneity was found, with rates of HP ranging from 12–79% across studies. Aggregate HP was 23% under a fixed effects model and 37% under random study effects. Clear systematic bias was also apparent, with disproportionate numbers of studies reporting HP rates markedly higher than the aggregate estimates (P< 0.0001). As expected, rates of HP were also strongly dependent on preoperative tumor size, with rates of 59%, 37%, and 11% observed for intracanalicular, small, and large (>20 mm) tumors, respectively. SIGNIFICANCE: HP rates are likely dependent on multiple factors, with tumor size as a strong effect. It is critical to discuss the patients expectations for HP when deciding treatment plans for VS.