Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2009
A meta-analysis of surgical treatment for vestibular schwannoma: is hospital volume related to preservation of facial function?
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Hastan Deniz, Vandenbroucke Jan P, van der Mey Andel G L
Аннотация
OBJECTIVE: To investigate the relation between hospital volume and preservation ratios of facial function in surgery for vestibular schwannoma.
DATA SOURCES: A meta-analysis was conducted on current literature concerning preservation ratios of facial function after surgical resection of vestibular schwannoma. Studies reported by the House-Brackmann grading system for facial function were searched; all studies were published in English in peer-reviewed journals between 1992 and 2007.
STUDY SELECTION: Articles had to report 1) patients who had surgery for vestibular schwannoma, 2) House-Brackmann grades for facial function, and 3) calendar time and number of procedures.
DATA EXTRACTION: Standard methods for meta-analysis were adapted.
DATA SYNTHESIS: Data were pooled by weighing studies according to their accuracy. Results were sorted for low-, moderate-, and high-volume hospitals. Linear relations were quantified by metaregression analysis (n = 5,560).
CONCLUSION: Findings of this meta-analysis suggest that there is a linear relation between hospital volume and preservation ratio of facial function. The concentration of surgical treatment might be a consideration to optimize clinical outcome. Prospective and nationwide registration of surgical results might contribute to more definitive conclusions regarding outcome of vestibular schwannoma surgery.
DATA SOURCES: A meta-analysis was conducted on current literature concerning preservation ratios of facial function after surgical resection of vestibular schwannoma. Studies reported by the House-Brackmann grading system for facial function were searched; all studies were published in English in peer-reviewed journals between 1992 and 2007.
STUDY SELECTION: Articles had to report 1) patients who had surgery for vestibular schwannoma, 2) House-Brackmann grades for facial function, and 3) calendar time and number of procedures.
DATA EXTRACTION: Standard methods for meta-analysis were adapted.
DATA SYNTHESIS: Data were pooled by weighing studies according to their accuracy. Results were sorted for low-, moderate-, and high-volume hospitals. Linear relations were quantified by metaregression analysis (n = 5,560).
CONCLUSION: Findings of this meta-analysis suggest that there is a linear relation between hospital volume and preservation ratio of facial function. The concentration of surgical treatment might be a consideration to optimize clinical outcome. Prospective and nationwide registration of surgical results might contribute to more definitive conclusions regarding outcome of vestibular schwannoma surgery.