scholarly journals Systematic Review of Hearing Preservation in Observed Vestibular Schwannoma

2019 ◽  
Vol 80 (02) ◽  
pp. 165-168 ◽  
Author(s):  
Martin Reznitsky ◽  
Per Cayé-Thomasen
Keyword(s):  
Systematic Review ◽  
Vestibular Schwannoma ◽  
Evaluation System ◽  
Pure Tone Audiometry ◽  
Weighted Average ◽  
Hearing Preservation ◽  
Neck Surgery ◽  
Cochrane Library ◽  
Discrimination Score ◽  
Spontaneous Course

Objective This is a systematic review of the literature on the spontaneous course of hearing in patients observed with a vestibular schwannoma. Included studies are appraised using the Grading of Recommendations Assessment, Development and Evaluation system. Design PubMed, Embase, Medline, Cochrane library, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for literature on hearing in patients observed with a vestibular schwannoma. Participants Of 217 evaluated papers, 15 were included, representing a total of 2,142 patients. Main Outcome Measures Hearing according to the AAO-HNS (American Academy of Otorhinolaryngology- Head and Neck Surgery) classification system. Weighted average of the proportion of patients preserving good hearing (>70% discrimination score and pure tone audiometry [PTA] < 30dB) and serviceable hearing (>50% discrimination score and PTA < 50dB) was determined. Results Fifty percent of patients presenting with good hearing at diagnosis had preserved this after a mean of 5 years of observation, whereas serviceable hearing was preserved in 54%. Patients with normal discrimination at diagnosis preserve their hearing very well. Very few studies exist on long-term hearing preservation. Conclusions After 5 years of observation, around half of patients will have preserved good or serviceable hearing. Patients with normal discrimination at diagnosis are more likely to preserve good hearing.

Effectiveness of Physiotherapy to Promote Motor Recovery in Individuals with Stroke: A Systematic Review Protocol

2022 ◽  
Author(s):  
Shehong Zhang ◽  
Hongyu Xie ◽  
Chuanjie Wang ◽  
Fengfeng Wu ◽  
Xin Wang
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Systematic Reviews ◽  
Evaluation System ◽  
Meta Analysis ◽  
Primary Data ◽  
Cochrane Library ◽  
Systematic Review Protocol ◽  
Qualitative Synthesis ◽  
Review Protocol

Abstract Introduction: Motor function is essential in our daily lives, one of the most common impairments caused by stroke is loss of functional movement. Over 70% of stroke survivors have motor or other neurological functional disabilities. However, rehabilitation of motor function suffered from a stroke can be rather difficult due to the complexity of organs and systems related to motor function, as well as the neural system that supported motor function. In particularly, previous evidence for the effectiveness of physiotherapy, a commonly prescribed intervention method for people with stroke, that recover motor function in people following a stroke is varied and limited in the chronic rehabilitation phase and therefore has never been reviewed systematically. With the progress of study in neurology and the development of novel tools for rehabilitation, results from more and more clinical trials are now available, thus here justifying conducting a systematic review. Methods and analysis: This systematic review protocol is developed in accordance with the methodology recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, as well as the Cochrane handbook for systematic reviews of interventions. Relevant studies will be identified by searching the databases. We will perform searches for relevant studies in databases, including PubMed, Embase, CINAHL, and Web of Science, Physiotherapy Evidence Database and Cochrane Library databases. The reference lists of included articles and reviews will be searched manually. The date range parameters used in searching all databases will be restricted between January 2001 and January 2021. Randomized controlled trials (RCTs) published will be included. The language used in the articles included was restricted to English. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation system from the Cochrane Handbook for Systematic Reviews of Interventions) approach will be used to systematically appraise the quality of methodology. We will assess the risk of bias of the RCTs included using the Cochrane Collaboration’s tool and provide a qualitative synthesis. After that, we will consider conducting a meta-analysis if the final data across outcomes shows sufficient homogeneity. Ethics and dissemination: No ethical approval is needed as the proposed study does not involve the collection of primary data, and the results of this review will be disseminated via peer-reviewed publications and conference presentations. Trial registration number: CRD42021267069.

scholarly journals Lasers in Cholesteatoma Surgery: A Systematic Review

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 94S-99S
Author(s):  
Kimberley Lau ◽  
Marios Stavrakas ◽  
Mark Yardley ◽  
Jaydip Ray
Keyword(s):  
Systematic Review ◽  
Current Literature ◽  
Normal Structure ◽  
Hearing Preservation ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Hearing Results ◽  
Disease Eradication ◽  
Mastoid Surgery ◽  
Cholesteatoma Surgery

Objectives: The mainstay of cholesteatoma treatment is surgical and requires the removal of all squamous epithelium from the underlying normal structure. The application of laser technology in middle ear and mastoid surgery has shown promise in achieving both disease eradication and hearing preservation. This systematic review aims to include studies that have assessed the application of laser to the treatment of cholesteatoma and to review its outcomes in terms of disease eradication as well as hearing results. Method: Two independent researchers conducted a systematic review of the literature on MEDLINE and Cochrane library, according to PRISMA guidance. Result: The search resulted in 12 papers, reporting on 536 participants that fulfilled the inclusion criteria. The hearing results did not show that using laser surgery improved hearing in cholesteatoma surgery, but neither has the use of laser shown to deteriorate hearing. With regards to the prevention of residual/recurrent cholesteatoma, the current literature reports a residual/recurrent rate of 0% to 33%. The complication rate of facial palsy is 0.6%. Conclusion: While there is certainly a role for future studies especially randomised large-cohort prospective comparative studies, the current literature suggests that laser may have a role in prevention or minimizing of residual cholesteatoma and generally have a safe hearing outcome profile.

Significance of Cochlear Dose in the Radiosurgical Treatment of Vestibular Schwannoma

Neurosurgery ◽  
2014 ◽  
Vol 74 (5) ◽  
pp. 466-474 ◽  
Author(s):  
Jeffrey T. Jacob ◽  
Matthew L. Carlson ◽  
Terry K. Schiefer ◽  
Bruce E. Pollock ◽  
Colin L. Driscoll ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Vestibular Schwannoma ◽  
Pure Tone ◽  
Interobserver Reliability ◽  
Univariate Analysis ◽  
Hearing Preservation ◽  
Neck Surgery ◽  
Tumor Control ◽  
Speech Discrimination ◽  
Pure Tone Average

Abstract BACKGROUND: Cochlear dose has been identified as a potentially modifiable contributor to hearing loss after stereotactic radiosurgery (SRS) for vestibular schwannoma (VS). OBJECTIVE: To evaluate the association between computed tomography-based volumetric cochlear dose and loss of serviceable hearing after SRS, to assess intraobserver and interobserver reliability when determining modiolar point dose with the use of magnetic resonance imaging and computed tomography, and to discuss the clinical significance of the cochlear dose with regard to radiosurgical planning strategy. METHODS: Patients with serviceable pretreatment hearing who underwent SRS for sporadic VS between the use of Gamma Knife Perfexion were studied. Univariate and multivariate associations with the primary outcome of time to nonserviceable hearing were evaluated. RESULTS: A total of 105 patients underwent SRS for VS during the study period, and 59 (56%) met study criteria and were analyzed. Twenty-one subjects (36%) developed nonserviceable hearing at a mean of 2.2 years after SRS (SD, 1.0 years; median, 2.1 years; range 0.6-3.8 years). On univariate analysis, pretreatment pure tone average, speech discrimination score, American Academy of Otolaryngology-Head and Neck Surgery hearing class, marginal dose, and mean dose to the cochlear volume were statistically significantly associated with time to nonserviceable hearing. However, after adjustment for baseline differences, only pretreatment pure tone average was statistically significantly associated with time to nonserviceable hearing in a multivariable model. CONCLUSION: Cochlear dose is one of many variables associated with hearing preservation after SRS for VS. Until further studies demonstrate durable tumor arrest with reduced dose protocols, routine tumor dose planning should not be modified to limit cochlear dose at the expense of tumor control.

Hearing preservation after stereotactic radiosurgery for vestibular schwannoma: A systematic review

2009 ◽  
Vol 16 (6) ◽  
pp. 742-747 ◽  
Author(s):  
Isaac Yang ◽  
Derrick Aranda ◽  
Seunggu J. Han ◽  
Sravana Chennupati ◽  
Michael E. Sughrue ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stereotactic Radiosurgery ◽  
Vestibular Schwannoma ◽  
Hearing Preservation

Stability of hearing preservation and regeneration capacity of the cochlear nerve following vestibular schwannoma surgery via a retrosigmoid approach

2016 ◽  
Vol 125 (5) ◽  
pp. 1277-1282 ◽  
Author(s):  
Christian Scheller ◽  
Andreas Wienke ◽  
Marcos Tatagiba ◽  
Alireza Gharabaghi ◽  
Kristofer F. Ramina ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Strong Association ◽  
Pure Tone Audiometry ◽  
Hearing Preservation ◽  
Cochlear Nerve ◽  
Speech Discrimination ◽  
Regeneration Capacity ◽  
Postoperative Course ◽  
Link Type ◽  
Hearing Abilities

OBJECTIVE The purpose of this research was to examine the stability of long-term hearing preservation and the regeneration capacity of the cochlear nerve following vestibular schwannoma (VS) surgery in a prospective study. METHODS A total of 112 patients were recruited for a randomized multicenter trial between January 2010 and April 2012 to investigate the efficacy of prophylactic nimodipine treatment versus no prophylactic nimodipine treatment in VS surgery. For the present investigation, both groups were pooled to compare hearing abilities in the early postoperative course and 1 year after the surgery. Hearing was examined using pure-tone audiometry with speech discrimination, which was performed preoperatively, in the early postoperative course, and 12 months after surgery and was subsequently classified by an independent otorhinolaryngologist using the Gardner-Robertson classification system. RESULTS Hearing abilities at 2 time points were compared by evaluation in the early postoperative course and 1 year after surgery in 102 patients. The chi-square test showed a very strong association between the 2 measurements in all 102 patients (p < 0.001) and in the subgroup of 66 patients with a preserved cochlear nerve (p < 0.001). CONCLUSIONS There is no significant change in cochlear nerve function between the early postoperative course and 1 year after VS surgery. The result of hearing performance, as evaluated by early postoperative audiometry after VS surgery, seems to be a reliable prognosticator for future hearing ability. Clinical trial registration nos.: 2009-012088-32 (clinicaltrialsregister.eu) and DRKS 00000328 (“AkNiPro,” drks-neu.uniklinik-freiburg.de/drks_web/)

Hearing preservation surgery in vestibular schwannoma

2006 ◽  
Vol 120 (5) ◽  
pp. 366-370 ◽  
Author(s):  
Tarek Khrais ◽  
Mario Sanna
Keyword(s):  
Vestibular Schwannoma ◽  
Tumour Size ◽  
Hearing Preservation ◽  
Neck Surgery ◽  
Hearing Level ◽  
Review Of Literature ◽  
Tertiary Referral Centre ◽  
Class A ◽  
Strong Inverse Relationship ◽  
Hearing Preservation Surgery

Objectives: To study the effect of pre-operative hearing level and tumour size on the hearing outcome of hearing preservation surgery for vestibular schwannoma.Study design and setting: A review of literature conducted at Gruppo Otologico, a tertiary referral centre for neurotology and skull base surgery.Results: A total of 1993 patients in 16 publications addressing the topic of hearing preservation surgery in vestibular schwannoma were analysed. The American Academy of Otolaryngology–Head and Neck Surgery hearing classification system was the classification upon which we based our analysis.Conclusion: Defining hearing preservation as class-A hearing, there was a strong inverse relationship between pre-operative hearing and post-operative hearing levels and between tumour size and post-operative hearing levels.

scholarly journals Effectiveness of preventive and treatment interventions for primary headaches in the workplace: A systematic review of the literature

Cephalalgia ◽  
2016 ◽  
Vol 37 (1) ◽  
pp. 64-73
Author(s):  
Arnaud Lardon ◽  
Marie-Pier Girard ◽  
Chérine Zaïm ◽  
Nadège Lemeunier ◽  
Martin Descarreaux ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evaluation System ◽  
Assessment Tool ◽  
Management Strategies ◽  
Internal Validity ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Primary Headaches ◽  
Work Related ◽  
Preventive Medication

Aim The purpose of this systematic literature review is to assess the benefits of workplace-based occupational therapies and interventions, including acute and preventive medication, on headache intensity and frequency, related disability as well as work-related outcomes. Methods A search of the literature was conducted in PubMed, MEDLINE, Cochrane library, CINAHL and Embase using terms related to headache, workplace and occupational health. The Cochrane Collaboration’s risk of bias assessment tool was used on individual studies to assess internal validity and the Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Results Fifteen articles were included in the systematic review. None of them were classified as low risk of bias according to the Cochrane Collaboration’s tool for assessing risk of bias. This systematic review found preliminary low-quality evidence suggesting that exercise and acupuncture can reduce workers’ headache pain intensity, frequency and related disability. Conclusion Although this systematic review provided preliminary low evidence in favour of work-based intervention, studies with more rigorous designs and methodologies are needed to provide further evidence of the effectiveness of workplace-based headache management strategies.

A Systematic Review of Quality Improvement Interventions in Burn Care

2021 ◽  
Author(s):  
Alan D Rogers ◽  
David L Wallace ◽  
Robert Cartotto
Keyword(s):  
Systematic Review ◽  
Quality Improvement ◽  
Full Text ◽  
Evaluation System ◽  
Scientific Evidence ◽  
Cochrane Library ◽  
Burn Care ◽  
Traditional Research ◽  
Improvement Interventions ◽  
Quality Improvement Interventions

Abstract Quality improvement interventions (QIIs) are intended to improve the care of patients. Unlike most traditional clinical research, these endeavors emphasize the sustainable implementation of scientific evidence rather than the establishment of evidence. Our purpose was to conduct a systematic review of QII publications in the field of burn care. A systematic review was conducted utilizing electronic databases (MEDLINE, Embase, and Cochrane Library) of all studies relating to “quality improvement” in burn care published until March 31, 2020. Studies were excluded if no baseline data were reported, or if no intervention was applied and tested. Studies were scored using a novel 10-point evaluation system for QII. We evaluated 414 studies involving “quality improvement” in burn care. Only 82 studies contained a QII while 332 studies were categorized as traditional research. Several traditional research studies made claims to be QIIs, but few met the criteria. Of the 82 QII references, only 20 (24%) were accessible as full-text manuscripts, the remainder were published as abstracts only. The mean score was 7.95 for full-text studies (range 6–10) and 7.4 for abstract-only studies (range 5.5–9.5). Despite the importance of quality improvement (QI) in burn care, very few studies have been published that employ true QI methodology, and many QII studies never advance beyond publication as abstracts in conference proceedings. Based on this systematic review, we propose guidelines to improve the quality of QII submissions.

scholarly journals Effectiveness of interventions to improve hand motor function in individuals with moderate to severe stroke: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e032413
Author(s):  
Hewei Wang ◽  
Ray Arceo ◽  
Shugeng Chen ◽  
Li Ding ◽  
Jie Jia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Systematic Reviews ◽  
Evaluation System ◽  
Meta Analysis ◽  
Hand Function ◽  
Cochrane Library ◽  
Systematic Review Protocol ◽  
Neural Basis ◽  
Review Protocol

IntroductionThe human hand is extremely involved in our daily lives. However, the rehabilitation of hand function after stroke can be rather difficult due to the complexity of hand structure and function, as well as neural basis that supports hand function. Specifically, in individuals with moderate to severe impairment following a stroke, previous evidence for effective treatments that recover hand function in this population is limited, and thus has never been reviewed. With the progress of rehabilitation science and tool development, results from more and more clinical trials are now available, thereby justifying conducting a systematic review.Methods and analysisThis systematic review protocol is consistent with the methodology recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the Cochrane handbook for systematic reviews of interventions. Electronic searches will be carried out in the PubMed, CINAHL, Physiotherapy Evidence Database and Cochrane Library databases, along with manual searches in the reference lists from included studies and published systematic reviews. The date range parameters used in searching all databases is between January 1999 and January 2019. Randomised controlled trials (RCTs) published in English, with the primary outcome focusing on hand motor function, will be included. Two reviewers will screen all retrieved titles, abstracts and full texts, perform the evaluation of the risk bias and extract all data independently. The risk of bias of the included RCTs will be evaluated by the Cochrane Collaboration’s tool. A qualitative synthesis will be provided in text and table, to summarise the main results of the selected publications. A meta-analysis will be considered if there is sufficient homogeneity across outcomes. The quality of the included publications will be evaluated by the Grading of Recommendations Assessment, Development and Evaluation system from the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationNo ethical approval is needed, and the results of this review will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberCRD42019128285.

scholarly journals Retrosigmoid Approach for Vestibular Schwannoma

2018 ◽  
Vol 80 (S 03) ◽  
pp. S271-S271
Author(s):  
Mohammed Aref ◽  
Katherine Kunigelis ◽  
Stephen P. Cass ◽  
A. Samy Youssef
Keyword(s):  
Vestibular Schwannoma ◽  
Tumor Resection ◽  
Internal Auditory Canal ◽  
Hearing Preservation ◽  
Neck Surgery ◽  
Cochlear Nerve ◽  
Management Options ◽  
Suppurative Otitis Media ◽  
History Of ◽  
The Right

Vestibular schwannoma is a benign tumor that affects 3% of the population, but accounts for 85% of tumors occurring at the cerebellopontine angle (CPA). In this case, we present a 48-year-old female with history of cholesteatoma on the right and chronic suppurative otitis media on the left who presented with an 18 month history of bilateral hearing loss, worse on the right. Investigations revealed a right sided vestibular schwannoma measuring 1.6 cm in diameter. Audiogram revealed an AAO–HNS (American Academy of Otolaryngology–Head and Neck Surgery) class C hearing on the right and class B on the left. There are several management options for this size of vestibular schwannoma including observation and radiosurgery. However, preserving cochlear nerve function remains a challenging enterprise. Furthermore, the ideal management that confers the highest chance of hearing preservation remains heavily debated. Given the patient's young age, the goal of hearing preservation and the tumor size/extension into the CPA, surgery was decided through a right retrosigmoid transmeatal approach for tumor resection with intraoperative brain auditory evoked responses monitoring. For hearing preservation, we emphasize few important dissection techniques: tumor debulking from the top first to avoid early manipulation of the cochlear nerve at the bottom of the tumor, sharp dissection from medial to lateral off the vestibular nerve which is kept intact as a tension band to minimize cochlear nerve manipulations, and limit the drilling of the posterolateral wall of the internal auditory canal (IAC) medial to the labyrinth and endolymphatic apparatus. Postoperatively, the patient was discharged home within 2 days, with imaging showing a gross total resection. Follow-up audiogram shows unchanged pure tone thresholds.The link to the Video can be found at: https://youtu.be/Z5ftkpJN5k8.

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