Outcomes of Near-Total and Subtotal Resection of Sporadic Vestibular Schwannoma: A Systematic Review and Meta-Analysis

Armine Kocharyan; Ghazal S Daher; Steven D Curry; Miles J Klimara; Nathan Farrokhian; Sarah Coleman; Jacob Oleson; Nauman F Manzoor; Matthew L Carlson

doi:10.1002/ohn.823

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Outcomes of Near-Total and Subtotal Resection of Sporadic Vestibular Schwannoma: A Systematic Review and Meta-Analysis

Journal article

Peer reviewed

Outcomes of Near-Total and Subtotal Resection of Sporadic Vestibular Schwannoma: A Systematic Review and Meta-Analysis

Armine Kocharyan, Ghazal S Daher, Steven D Curry, Miles J Klimara, Nathan Farrokhian, Sarah Coleman, Jacob Oleson, Nauman F Manzoor and Matthew L Carlson

Otolaryngology-head and neck surgery, Vol.171(3), pp.642-657

06/01/2024

DOI: 10.1002/ohn.823

PMID: 38822753

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Abstract

To evaluate tumor control and facial nerve outcomes after gross-total (GTR), near-total (NTR), and subtotal resection (STR) of sporadic vestibular schwannomas (VS). PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched in August 2021 through inception following PRISMA guidelines. English language articles reporting tumor control and facial nerve outcomes of adults (≥18 years) with NTR and STR of VS were evaluated. Study characteristics, demographics data, tumor characteristics, type of surgical intervention, and outcome measures on tumor control and facial nerve function were collected. Pooled relative risk (RR) estimates for tumor recurrence and facial nerve outcomes were calculated and stratified by extent of resection. From an initial search of 2504 articles, 48 studies were included in the analysis. When comparing 1108 patients who underwent NTR to 3349 patients with GTR, the pooled RR of recurrence in the NTR cohort was 2.94 (95% confidence interval [CI] 1.65-5.24, P = .0002). When comparing 1016 patients who underwent STR to 6171 patients with GTR, the pooled RR of recurrence in the STR cohort was 11.50 (95% CI 6.64-19.92, P < .0001). Estimates for risk of tumor regrowth for less-than-complete resection are presented. There was no elevated risk of adverse facial nerve outcome (defined as House-Brackmann grade III and above) in each category of extent of resection compared to GTR. Extent of resection predicts risk of tumor recurrence/regrowth following microsurgical resection. Favorable facial nerve outcome should be weighed against the increased risk of regrowth and the potential need for further treatment.

tumor control

subtotal resection

near‐total resection

facial nerve outcomes

vestibular schwannoma

Details

Title: Subtitle: Outcomes of Near-Total and Subtotal Resection of Sporadic Vestibular Schwannoma: A Systematic Review and Meta-Analysis
Creators: Armine Kocharyan - House Clinic
Ghazal S Daher - Mayo Clinic
Steven D Curry - House Clinic
Miles J Klimara - University of Iowa
Nathan Farrokhian - University of Kansas Medical Center
Sarah Coleman - University of Iowa
Jacob Oleson - University of Iowa
Nauman F Manzoor - Virginia Commonwealth University
Matthew L Carlson - Mayo Clinic
Resource Type: Journal article
Publication Details: Otolaryngology-head and neck surgery, Vol.171(3), pp.642-657
DOI: 10.1002/ohn.823
PMID: 38822753
NLM abbreviation: Otolaryngol Head Neck Surg
eISSN: 1097-6817
Language: English
Electronic publication date: 06/01/2024
Academic Unit: Biostatistics; Otolaryngology
Record Identifier: 9984634259902771

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