Ahsan Syed F, Huq Farhan, Seidman Michael, Taylor Andrew
*Department of Otolaryngology†Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, Michigan.
Otol Neurotol. 2017 Dec;38(10):1505-1511. doi: 10.1097/MAO.0000000000001560.
The objective is to perform a systematic review and meta-analysis of the literature on the long-term results of hearing preservation after vestibular schwannoma resection.
Ovid/Medline, PubMed, Embase, and the Cochrane library from January 1980 to January 2015.
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.
Quality evaluated using Methodological Index for Non-Randomized Studies.
Meta-analysis was performed using R v3.2.2, Metafor package v 1.9-7. Cohen's D was used to determine effect size. Ten reports had at least 5-year follow-up and used standardized hearing grading scales. 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.
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 postoperative pure-tone average was associated with long-term hearing durability.
对听神经瘤切除术后听力保留的长期结果相关文献进行系统评价和荟萃分析。
1980年1月至2015年1月的Ovid/Medline、PubMed、Embase和Cochrane图书馆。
纳入标准：年龄≥18岁，治疗组至少10例患者，听力保留显微手术，既往未接受过放射治疗，术后即刻随访时听力可用，使用Gardner Robinson或美国耳鼻咽喉-头颈外科学会听力分级量表报告听力结果，平均随访5年。需要术前、术后即刻和末次随访的听力图。排除标准包括2型神经纤维瘤病患者以及挽救治疗或减压手术。
使用非随机研究方法学指数评估质量。
使用R v3.2.2、Metafor软件包v 1.9 - 7进行荟萃分析。使用Cohen's D确定效应量。十篇报告至少有5年随访并使用标准化听力分级量表。系统评价发现，如果术后早期听力保留在A或B级，5年时保留听力的机会很好。术后早期随访时言语辨别得分≥89%的患者长期听力保留更好。荟萃分析显示，只有术前和术后纯音平均值与长期听力保留相关。
长期（>5年）听力持久率总体上非常好。大多数研究未报告患者和肿瘤特征，因此无法合并研究进行荟萃分析。只有术前和术后纯音平均值与长期听力持久性相关。
