Gan Jinlu, Zhang Yanling, Wu Jingnan, Lei Deqiang, Zhang Fangcheng, Zhao Hongyang, Wang Lei
Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2021 Aug 12;11:687201. doi: 10.3389/fonc.2021.687201. eCollection 2021.
Hearing loss is the most common initial symptom in patients with sporadic vestibular schwannomas (SVS). Hearing preservation is an important goal of both conservative and surgical therapy. However, the mechanism of SVS-associated hearing loss remains unclear. Thus, we performed this systematic review to summarize the current understanding of hearing loss in the SVS and distill a testable hypothesis to further illuminate its underlying mechanism.
A systematic review querying four databases (PubMed, Medline, Embase, and Web of Science) was performed to identify studies evaluating hearing loss in patients with SVS and exploring the potential mechanisms of hearing impairment.
A total of 50 articles were eligible and included in this review. After analysis, the retrieved studies could be categorized into four types: (1) 29 studies explore the relationship between hearing loss and the growth pattern of the tumor (e.g., tumor size/volume, growth rate, tumor location, .); (2) ten studies investigate the potential role of cochlear dysfunction in hearing deterioration, including structural abnormality, protein elevation in perilymph, and cochlear malfunctioning; (3) two studies looked into SVS-induced impairment of auditory pathway and cortex; (4) in the rest nine studies, researchers explored the molecular mechanism underlying hearing loss in SVS, which involves molecular and genetic alterations, inflammatory response, growth factors, and other tumor-associated secretions.
Multiple factors may contribute to the hearing impairment in SVS, including the growth pattern of tumor, cochlear dysfunction, impairment of auditory pathway and cortex, genetic and molecular changes. However, our current understanding is still limited, and future studies are needed to explore this multifactorial hypothesis and dig deeper into its underlying mechanism.
听力损失是散发性前庭神经鞘瘤（SVS）患者最常见的初始症状。听力保留是保守治疗和手术治疗的重要目标。然而，SVS相关听力损失的机制仍不清楚。因此，我们进行了这项系统评价，以总结目前对SVS听力损失的认识，并提炼出一个可检验的假设，以进一步阐明其潜在机制。
进行一项系统评价，检索四个数据库（PubMed、Medline、Embase和Web of Science），以识别评估SVS患者听力损失并探索听力障碍潜在机制的研究。
共有50篇文章符合纳入本评价的标准并被纳入。经过分析，检索到的研究可分为四类：（1）29项研究探讨了听力损失与肿瘤生长模式之间的关系（如肿瘤大小/体积、生长速率、肿瘤位置等）；（2）10项研究调查了耳蜗功能障碍在听力减退中的潜在作用，包括结构异常、外淋巴中蛋白质升高和耳蜗功能障碍；（3）2项研究探讨了SVS引起的听觉通路和皮层损伤；（4）其余9项研究中，研究人员探索了SVS听力损失的分子机制，其中涉及分子和基因改变、炎症反应、生长因子及其他肿瘤相关分泌物。
多种因素可能导致SVS患者听力障碍，包括肿瘤生长模式、耳蜗功能障碍、听觉通路和皮层损伤、基因和分子变化。然而，我们目前的认识仍然有限，未来需要开展研究来探索这一多因素假设，并更深入地探究其潜在机制。
