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Comparison of surgical outcomes in cystic and solid vestibular schwannomas: a systematic review and meta-analysis

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Abstract

Most studies reported that cystic vestibular schwannoma (CVS) surgery has a less favourable prognosis than solid vestibular schwannoma (SVS) surgery. However, some studies report that it is unclear whether surgical outcomes for these conditions exhibit significant differences. The aim of this meta-analysis was to pool the current literature and describe and analyse any differences in the clinical symptoms and surgical outcomes among CVS and SVS. PubMed, Embase, and Cochrane databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines through April 22, 2020. Outcomes were analysed using a meta-analysis of the proportions. The results of the search yielded 17 studies that met the criteria for inclusion and analysis, involving 3074 participants (including 821 patients with CVSs and 2253 patients with SVSs). No significant differences in the extent of tumour resection (gross-total resection versus non-gross-total resection; RR, 0.93; 95% CI, 0.86–1.01; p = 0.096) and most other outcomes were noted between CVS and SVS cohorts. However, facial nerve function (House-Brackmann Grade I or II versus III or more) of CVS patients was worse (RR, 0.86; 95% CI, 0.78–0.93; p < 0.001) compared with SVS patients with more than 1 year of follow-up after surgery. The criteria of cystic acoustic neuroma needs to be further unified, and prospective cohort studies with larger sample sizes should be performed for further verification of these results in the future.

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Acknowledgements

The authors sincerely thank all colleagues of neurosurgery department in Xuan Wu Hospital. We thank Jiantao Liang, MD, for his critical review of the manuscript.

Funding

Beijing Medical Authority’s “Sailing” Plan (XMLX201821).

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Authors and Affiliations

  1. Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China

    Xiaolong Wu, Gang Song, Xu Wang, Mingchu Li, Ge Chen, Hongchuan Guo, Yuhai Bao & Jiantao Liang

  2. International Neuroscience Institute (China-INI), Beijing, China

    Xiaolong Wu, Gang Song, Xu Wang, Mingchu Li, Ge Chen, Hongchuan Guo, Yuhai Bao & Jiantao Liang

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  1. Xiaolong Wu
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Contributions

Literature search: Xiaolong Wu, Gang Song, and Jiantao Liang.

Extraction of data: Xiaolong Wu, Gang Song, and Xu Wang.

Quality assessment: Xiaolong Wu, Gang Song, and Jiantao Liang.

Statistical analysis and Writing original draft: Xiaolong Wu.

Review and Editing: Mingchu Li, Ge Chen, Hongchuan Guo, Yuhai Bao, and Jiantao Liang.

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Correspondence to Jiantao Liang.

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This article does not contain any studies with human participants or animals performed by any of the authors. Only published studies were used for our analysis, and no patient medical records were accessed in completing this article. Thus, patients’ consent was not required.

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Wu, X., Song, G., Wang, X. et al. Comparison of surgical outcomes in cystic and solid vestibular schwannomas: a systematic review and meta-analysis. Neurosurg Rev 44, 1889–1902 (2021). https://doi.org/10.1007/s10143-020-01400-5

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