Almufarrij Ibrahim, Hannan Cathal John, King Andrew Thomas, Vail Andy, Heal Calvin, Whitfield Gillian, Pathmanaban Omar Nathan, Lloyd Simon K, Munro Kevin J
Manchester Centre for Audiology and Deafness, School of Health Sciences, The University of Manchester, Manchester, United Kingdom.
Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
J Neurol Surg B Skull Base. 2023 Feb 22;85(2):123-130. doi: 10.1055/a-2021-8762. eCollection 2024 Apr.
Evidence on hearing outcome measures when assessing hearing preservation following stereotactic radiosurgery (SRS) for adults with vestibular schwannoma (VS) has not previously been collated in a structured review. The objective of the present study was to perform a scoping review of the evidence regarding the choice of hearing outcomes and other methodological characteristics following SRS for adults with VS. The protocol was registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses extension guidelines for scoping reviews. A systematic search of five online databases revealed 1,591 studies, 247 of which met the inclusion criteria. The majority of studies ( = 213, 86%) were retrospective cohort or case series with the remainder ( = 34, 14%) prospective cohort. Pure-tone audiometry and speech intelligibility were included in 222 (90%) and 158 (64%) studies, respectively, often summarized within a classification scheme and lacking procedural details. Fifty-nine (24%) studies included self-report measures. The median duration of follow-up, when reported, was 43 months (interquartile range: 29, 4-150). Evidence on hearing disability after SRS for VS is based on low-quality studies which are inherently susceptible to bias. This review has highlighted an urgent need for a randomized controlled trial assessing hearing outcomes in patients with VS managed with radiosurgery or radiological observation. Similarly, consensus and coproduction of a core outcome set to determine relevant hearing and communication outcome domains is required. This will ensure that patient priorities, including communication abilities in the presence of background noise and reduced participation restrictions, are addressed.
在评估立体定向放射外科手术（SRS）治疗成人前庭神经鞘瘤（VS）后听力保留情况时，此前尚未对听力结果测量方面的证据进行结构化综述。本研究的目的是对SRS治疗成人VS后听力结果选择及其他方法学特征的证据进行范围综述。该方案已在国际注册系统评价和Meta分析方案平台（INPLASY）注册，并根据系统评价和Meta分析扩展指南中范围综述的首选报告项目进行报告。对五个在线数据库进行系统检索后发现了1591项研究，其中247项符合纳入标准。大多数研究（n = 213，86%）为回顾性队列研究或病例系列研究，其余（n = 34，14%）为前瞻性队列研究。分别有222项（90%）和158项（64%）研究纳入了纯音听力测定和言语清晰度，这些结果通常在一个分类方案中进行总结，且缺乏程序细节。59项（24%）研究纳入了自我报告测量。报告的随访中位持续时间为43个月（四分位间距：29，4 - 150）。SRS治疗VS后听力残疾的证据基于低质量研究，这些研究本身容易产生偏倚。本综述强调迫切需要进行一项随机对照试验，以评估接受放射外科手术或放射观察治疗的VS患者的听力结果。同样，需要就确定相关听力和沟通结果领域的核心结局集达成共识并共同制定。这将确保解决患者的优先事项，包括在存在背景噪音时的沟通能力以及减少参与限制。
