Comparison of translabyrinthine and retrosigmoid approach for treating vestibular schwannoma: A meta-analysis.
Clin Neurol Neurosurg. 2020 09; 196:105994.CN

Abstract

BACKGROUND

To date, the literature directly comparing the translabyrinthine approach and retrosigmoid approach in the operation of patients with vestibular schwannoma was limited. We aimed to evaluate postoperative complications between translabyrinthine approach and retrosigmoid approach for treating vestibular schwannoma patients.

MATERIAL AND METHOD

Potential publications were selected from PubMed, Web of Science and Cochrane Library. Gray relevant studies were manually searched. We set the searching time spanning from the creation date of electronic engines to February 2020. STATA version 12.0 was exerted to process the pooled data.

RESULTS

A total of 9 literature included in the study, involving 2429 patients, hails from the Germany, USA, Canada, Italy, and France. Of these 2429 patients with vestibular schwannoma, there were 1628 cases from the translabyrinthine approach group versus 801 cases from the retrosigmoid approach group. The results demonstrated that the translabyrinthine approach group was associated with a lower rate of tinnitus (OR = 2.687; 95 %CI, 1.167-6.191; P = 0.02) and cranial nerve deficit (OR = 2.946; 95 %CI, 1.562-5.557; P = 0.001). And the translabyrinthine approach group was associated with a higher total resection rate (OR = 0.246; 95 %CI (0.071-0.848); P = 0.026). However, no statistic differences were found in the incidence of the near total (OR = 0.751; P = 0.351), subtotal resection (OR = 3.664; P = 0.109), postoperative facial nerve dysfunctions (OR, 0.763; P = 0.626), postoperative meningitis (OR = 2.7; P = 0.279), cerebrospinal fluid leak (OR = 1.225; P = 0.777), postoperative headache (OR = 1.412; P = 0.339), ophthalmic complications (OR = 0.87; P = 0.59), and vascular complications (OR = 2.501; P = 0.139).

CONCLUSION

Based on current evidence, the translabyrinthine approach was associated with a higher rate of total resection and a lower rate of the tinnitus and cranial nerve deficit. But the risk of cranial nerve deficit was clearly affected by the preoperative status. And a translabyrintine approach could imply a complete sensorineural hearing loss, which contribute to the lower rate of postoperative tinnitus. Consequently, more evidence-based researches are needed to supplement this opinion.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Jun W

Department of Neurosurgery, The Fifth Affiliated Hospital of Nanchang University (Fu Zhou First People's Hospital of Jiangxi Province), Fuzhou, Jiangxi, 344000 PR China. Electronic address: 1353330962@qq.com.

MeSH

Cerebrospinal Fluid LeakCranial Nerve InjuriesCraniotomyHeadache Disorders, SecondaryHumansIncidenceMeningitisNeuroma, AcousticObservational Studies as TopicOccipital BonePostoperative ComplicationsRandomized Controlled Trials as TopicTinnitusTreatment OutcomeVascular DiseasesVestibule, LabyrinthVision Disorders

Pub Type(s)

Comparative Study

Journal Article

Meta-Analysis

Systematic Review

Language

eng

PubMed ID

32540713

Citation

Jun, Wu, et al. "Comparison of Translabyrinthine and Retrosigmoid Approach for Treating Vestibular Schwannoma: a Meta-analysis." Clinical Neurology and Neurosurgery, vol. 196, 2020, p. 105994.

Jun W, Gao YL, Yu HG, et al. Comparison of translabyrinthine and retrosigmoid approach for treating vestibular schwannoma: A meta-analysis. Clin Neurol Neurosurg. 2020;196:105994.

Jun, W., Gao, Y. L., Yu, H. G., Huang, Q. L., Long, X. Q., Liu, G. H., Ting, X., Zhong, X. Y., & Zhou, Y. F. (2020). Comparison of translabyrinthine and retrosigmoid approach for treating vestibular schwannoma: A meta-analysis. Clinical Neurology and Neurosurgery, 196, 105994. https://doi.org/10.1016/j.clineuro.2020.105994

Jun W, et al. Comparison of Translabyrinthine and Retrosigmoid Approach for Treating Vestibular Schwannoma: a Meta-analysis. Clin Neurol Neurosurg. 2020;196:105994. PubMed PMID: 32540713.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Comparison of translabyrinthine and retrosigmoid approach for treating vestibular schwannoma: A meta-analysis. AU - Jun,Wu, AU - Gao,Yun-Long, AU - Yu,Hai-Guang, AU - Huang,Qing-Liang, AU - Long,Xin-Quan, AU - Liu,Guo-Hua, AU - Ting,Xu, AU - Zhong,Xiu-Ying, AU - Zhou,Yu-Fan, Y1 - 2020/06/06/ PY - 2020/04/24/received PY - 2020/06/03/revised PY - 2020/06/05/accepted PY - 2020/6/17/pubmed PY - 2021/6/22/medline PY - 2020/6/17/entrez KW - Retrosigmoid KW - Translabyrinthine KW - Vestibular schwannoma SP - 105994 EP - 105994 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 196 N2 - BACKGROUND: To date, the literature directly comparing the translabyrinthine approach and retrosigmoid approach in the operation of patients with vestibular schwannoma was limited. We aimed to evaluate postoperative complications between translabyrinthine approach and retrosigmoid approach for treating vestibular schwannoma patients. MATERIAL AND METHOD: Potential publications were selected from PubMed, Web of Science and Cochrane Library. Gray relevant studies were manually searched. We set the searching time spanning from the creation date of electronic engines to February 2020. STATA version 12.0 was exerted to process the pooled data. RESULTS: A total of 9 literature included in the study, involving 2429 patients, hails from the Germany, USA, Canada, Italy, and France. Of these 2429 patients with vestibular schwannoma, there were 1628 cases from the translabyrinthine approach group versus 801 cases from the retrosigmoid approach group. The results demonstrated that the translabyrinthine approach group was associated with a lower rate of tinnitus (OR = 2.687; 95 %CI, 1.167-6.191; P = 0.02) and cranial nerve deficit (OR = 2.946; 95 %CI, 1.562-5.557; P = 0.001). And the translabyrinthine approach group was associated with a higher total resection rate (OR = 0.246; 95 %CI (0.071-0.848); P = 0.026). However, no statistic differences were found in the incidence of the near total (OR = 0.751; P = 0.351), subtotal resection (OR = 3.664; P = 0.109), postoperative facial nerve dysfunctions (OR, 0.763; P = 0.626), postoperative meningitis (OR = 2.7; P = 0.279), cerebrospinal fluid leak (OR = 1.225; P = 0.777), postoperative headache (OR = 1.412; P = 0.339), ophthalmic complications (OR = 0.87; P = 0.59), and vascular complications (OR = 2.501; P = 0.139). CONCLUSION: Based on current evidence, the translabyrinthine approach was associated with a higher rate of total resection and a lower rate of the tinnitus and cranial nerve deficit. But the risk of cranial nerve deficit was clearly affected by the preoperative status. And a translabyrintine approach could imply a complete sensorineural hearing loss, which contribute to the lower rate of postoperative tinnitus. Consequently, more evidence-based researches are needed to supplement this opinion. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/32540713/Comparison_of_translabyrinthine_and_retrosigmoid_approach_for_treating_vestibular_schwannoma:_A_meta_analysis_ DB - PRIME DP - Unbound Medicine ER -

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Comparison of translabyrinthine and retrosigmoid approach for treating vestibular schwannoma: A meta-analysis.Clin Neurol Neurosurg. 2020 09; 196:105994.CN