Translabyrinthine versus Retrosigmoid Approach for Vestibular Schwannoma: A Systematic Review and An Updated Meta-Analysis

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dc.contributor.authorGibbon F.L.
dc.contributor.authorLindner R.J.
dc.contributor.authorVial A.D.M.
dc.contributor.authorda Silva G.G.
dc.contributor.authorPalavani L.B.
dc.contributor.authorSemione G.
dc.contributor.authorWorm P.V.
dc.contributor.authorIsolan G.R.
dc.contributor.authorda Silva V.A.R.
dc.contributor.authorBento R.F.
dc.contributor.authorFriedman R.A.
dc.contributor.authorLavinsky J.
dc.date.accessioned2024-11-01T06:13:03Z
dc.date.available2024-11-01T06:13:03Z
dc.date.issued2024
dc.description.abstract© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.Objective: Several approaches can be used in the surgical treatment of vestibular schwannoma (VS), and the best approach remains uncertain in the literature. This systematic review and meta-analysis aim to compare the translabyrinthine approach (TLA) with the retrosigmoid approach (RSA) for VS in terms of postoperative complications. Data Sources: PubMed, Web of Science, Embase, and Cochrane. Review Methods: The primary outcome was cerebrospinal fluid (CSF) leak; secondary outcomes were facial nerve dysfunction (FND), length of stay (LOS), and meningitis. Statistical analysis was performed using RStudio 2024.04.1 + 748. Heterogeneity was assessed with I² statistics. We performed sensitivity analysis with subgroup analysis and meta-regression. Risk of bias was assessed using ROBINS-I. Results: Out of 1140 potential articles, 21 met the inclusion criteria. Among the 4572 patients, 2687 and 1885 patients in the TLA and RSA groups, respectively. No significant differences were found in CSF leak (odds ratio [OR] 1.03; 95% confidence interval [CI] 0.81,1.32; P =.794) or meningitis (OR 1.05; 95% CI 0.45, 2.43; P =.73). Meta-regression showed no association with CSF leak and the number of cases per center or publication year. The TLA is associated with a shorter LOS (MD −1.20; 95% CI −1.39, −1.01; P <.01) and a higher chance of having and HB 4 or lower compared to patients who underwent RSA (OR 0.30; 95% CI 0.10, 0.89; P =.03). Conclusion: There was no difference in the odds of CSF leak or meningitis between the groups. In addition, the TLA has a shorter LOS and a higher chance of a better facial nerve outcome compared to the RSA.
dc.identifier.doi10.1002/ohn.1031
dc.identifier.issnNone
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/39681
dc.relation.ispartofOtolaryngology - Head and Neck Surgery (United States)
dc.rightsAcesso Restrito
dc.subject.otherlanguagecerebrospinal fluid leak
dc.subject.otherlanguagefacial nerve dysfunction
dc.subject.otherlanguagelength of stay
dc.subject.otherlanguageretrosigmoid approach
dc.subject.otherlanguagetranslabyrinthine approach
dc.subject.otherlanguagevestibular schwannoma
dc.titleTranslabyrinthine versus Retrosigmoid Approach for Vestibular Schwannoma: A Systematic Review and An Updated Meta-Analysis
dc.typeArtigo de revisão
local.scopus.citations0
local.scopus.eid2-s2.0-85207282798
local.scopus.updated2024-12-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85207282798&origin=inward
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