Comparison of surgical outcomes in cystic and solid vestibular schwannomas: a systematic review and meta-analysis
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REVIEW
Comparison of surgical outcomes in cystic and solid vestibular schwannomas: a systematic review and meta-analysis Xiaolong Wu 1,2 & Gang Song 1,2 & Xu Wang 1,2 & Mingchu Li 1,2 & Ge Chen 1,2 & Hongchuan Guo 1,2 & Yuhai Bao 1,2 & Jiantao Liang 1,2 Received: 1 July 2020 / Revised: 30 August 2020 / Accepted: 21 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Cystic vestibular schwannoma . Solid vestibular schwannoma . Surgical outcomes . Gross-total resection . Facial nerve function
Introduction Vestibular schwannoma (VS) is a benign intracranial spaceoccupying lesion in the cerebellopontine angle (CPA), accounting for approximately 6–8% of intracranial tumours and greater than 80% of all cerebellopontine angle tumours [3, 11, 19, 37]. These tumours are classified as solid vestibular schwannoma (SVS) and cystic vestibular schwannoma (CVS) based on their consistency. Most VSs are solid, and CVSs are Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10143-020-01400-5) contains supplementary material, which is available to authorized users. * Jiantao Liang [email protected] 1
Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China
2
International Neuroscience Institute (China-INI), Beijing, China
relatively rare [23, 31, 39]. The reported incidence of CVSs varies from 4 to 23% according to a systematic analysis of the literature [39]. Compared to SVSs, most studies reported that CVS tumour ch
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