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World Neurosurgery Sep 2022Vestibular schwannomas are benign, slow-growing tumors that often reduce patient quality of life by compressing nearby nerves. Neurological function preservation is one... (Review)
Review
OBJECTIVE
Vestibular schwannomas are benign, slow-growing tumors that often reduce patient quality of life by compressing nearby nerves. Neurological function preservation is one of the indicators of treatment success, with hearing preservation being the most difficult to obtain. This paper provides a bibliometric analysis of hearing preservation in treating acoustic neuromas and a greater understanding of the most highly cited articles, which have enhanced our understanding of this topic.
METHODS
Key terms of "acoustic neuroma," "vestibular schwannoma," and "hearing preservation" were queried through Web of Science. Articles were sorted by citation frequency, and the top 100 articles were recorded for title, name of first author, journal title, year of publication, total number of citations (and associated rank), average number of citations per year, country of the first author's associated institution, and type of study.
RESULTS
The top 100 cited articles were published from 1980 to 2014. The United States had the highest involvement as a country (55%), the University of Pittsburgh as an institution (13%), and The Journal of Neurosurgery as a publishing source (27%). Fourteen were reviews, and 86 were clinical papers. Of the 86, 73 were retrospective studies.
CONCLUSION
Bibliometric analyses summarize and assess potential areas of strength and knowledge gaps within the literature. Studies on hearing preservation in vestibular schwannomas mostly consist of retrospective reviews that assess postoperative outcomes of microsurgery and radiosurgery. Prospective studies and novel treatment options for hearing preservation in vestibular schwannomas are needed to increase current literature diversity.
Topics: Hearing; Humans; Neuroma, Acoustic; Prospective Studies; Quality of Life; Radiosurgery; Retrospective Studies
PubMed: 35779753
DOI: 10.1016/j.wneu.2022.06.120 -
AJNR. American Journal of Neuroradiology Nov 2017Vestibular schwannomas are the most common cerebellopontine angle tumor. During the past century, the management goals of vestibular schwannomas have shifted from total... (Review)
Review
Vestibular schwannomas are the most common cerebellopontine angle tumor. During the past century, the management goals of vestibular schwannomas have shifted from total resection to functional preservation. Current treatment options include surgical resection, stereotactic radiosurgery, and observation. Imaging has become a crucial part of the initial screening, evaluation, and follow-up assessment of vestibular schwannomas. Recognizing and understanding the management objectives, various treatment modalities, expected posttreatment findings, and complications allows the radiologist to play an essential role in a multidisciplinary team by providing key findings relevant to treatment planning and outcome assessment. The authors provide a comprehensive discussion of the surgical management, role of radiation therapy and observation, imaging differential, and pre- and posttreatment imaging findings of vestibular schwannomas.
Topics: Cerebellar Neoplasms; Cerebellopontine Angle; Humans; Neuroma, Acoustic; Neurosurgical Procedures; Treatment Outcome
PubMed: 28546250
DOI: 10.3174/ajnr.A5213 -
Neurology India 2022Hearing preservation in vestibular schwannoma resection is a much-discussed topic in these times of functional preservation. Irrespective of the mode of treatment of... (Review)
Review
BACKGROUND
Hearing preservation in vestibular schwannoma resection is a much-discussed topic in these times of functional preservation. Irrespective of the mode of treatment of large tumors, this becomes possible only in a lucky few. The overall burden of such deaf patients is on a rising trend, and therefore, it is high time neurosurgeons look into this often-neglected area of hearing rehabilitation.
OBJECTIVES
In this review, the authors intend to provide a glimpse of available hearing rehabilitation modalities in the present era.
MATERIALS AND METHODS
: This review deals with both immediate and long-term hearing outcomes following both surgery and stereotactic radiosurgery for sporadic vestibular schwannoma and the need for hearing rehabilitation in these patients. Various databases, including PubMed, Medline/Medscape, Scopus, Cochrane, and Google Scholar were searched to find available literature on hearing rehabilitation after treatment of sporadic vestibular schwannoma. The searched MeSH terms were "Hearing", "Vestibular schwannoma", "Rehabilitation", and "Acoustic Neuroma", alone and in various combinations.
RESULTS
: The authors were surprised to find a paucity of literature. Even though neurosurgeons are at the forefront in managing vestibular schwannoma, they are not actively involved in hearing rehabilitation techniques possible for those who are rendered deaf following treatment.
CONCLUSIONS
: The authors strongly believe that this review will be a wake-up call for neurosurgeons on a relatively untouched topic.
Topics: Hearing; Hearing Tests; Humans; Neuroma, Acoustic; Radiosurgery; Treatment Outcome
PubMed: 35864608
DOI: 10.4103/0028-3886.349600 -
Environment International Mar 2024Each new generation of mobile phone technology has triggered discussions about potential carcinogenicity from exposure to radiofrequency electromagnetic fields (RF-EMF)....
BACKGROUND
Each new generation of mobile phone technology has triggered discussions about potential carcinogenicity from exposure to radiofrequency electromagnetic fields (RF-EMF). Available evidence has been insufficient to conclude about long-term and heavy mobile phone use, limited by differential recall and selection bias, or crude exposure assessment. The Cohort Study on Mobile Phones and Health (COSMOS) was specifically designed to overcome these shortcomings.
METHODS
We recruited participants in Denmark, Finland, the Netherlands, Sweden, and the UK 2007-2012. The baseline questionnaire assessed lifetime history of mobile phone use. Participants were followed through population-based cancer registers to identify glioma, meningioma, and acoustic neuroma cases during follow-up. Non-differential exposure misclassification was reduced by adjusting estimates of mobile phone call-time through regression calibration methods based on self-reported data and objective operator-recorded information at baseline. Hazard ratios (HR) and 95% confidence intervals (CI) for glioma, meningioma, and acoustic neuroma in relation to lifetime history of mobile phone use were estimated with Cox regression models with attained age as the underlying time-scale, adjusted for country, sex, educational level, and marital status.
RESULTS
264,574 participants accrued 1,836,479 person-years. During a median follow-up of 7.12 years, 149 glioma, 89 meningioma, and 29 incident cases of acoustic neuroma were diagnosed. The adjusted HR per 100 regression-calibrated cumulative hours of mobile phone call-time was 1.00 (95 % CI 0.98-1.02) for glioma, 1.01 (95 % CI 0.96-1.06) for meningioma, and 1.02 (95 % CI 0.99-1.06) for acoustic neuroma. For glioma, the HR for ≥ 1908 regression-calibrated cumulative hours (90th percentile cut-point) was 1.07 (95 % CI 0.62-1.86). Over 15 years of mobile phone use was not associated with an increased tumour risk; for glioma the HR was 0.97 (95 % CI 0.62-1.52).
CONCLUSIONS
Our findings suggest that the cumulative amount of mobile phone use is not associated with the risk of developing glioma, meningioma, or acoustic neuroma.
Topics: Humans; Meningioma; Cohort Studies; Neuroma, Acoustic; Prospective Studies; Cell Phone Use; Brain Neoplasms; Glioma; Electromagnetic Fields; Cell Phone; Surveys and Questionnaires; Meningeal Neoplasms; Case-Control Studies
PubMed: 38458118
DOI: 10.1016/j.envint.2024.108552 -
Nature Communications Jan 2024Vestibular schwannomas (VS) are benign tumors that lead to significant neurologic and otologic morbidity. How VS heterogeneity and the tumor microenvironment (TME)...
Vestibular schwannomas (VS) are benign tumors that lead to significant neurologic and otologic morbidity. How VS heterogeneity and the tumor microenvironment (TME) contribute to VS pathogenesis remains poorly understood. In this study, we perform scRNA-seq on 15 VS, with paired scATAC-seq (n = 6) and exome sequencing (n = 12). We identify diverse Schwann cell (SC), stromal, and immune populations in the VS TME and find that repair-like and MHC-II antigen-presenting SCs are associated with myeloid cell infiltrate, implicating a nerve injury-like process. Deconvolution analysis of RNA-expression data from 175 tumors reveals Injury-like tumors are associated with larger tumor size, and scATAC-seq identifies transcription factors associated with nerve repair SCs from Injury-like tumors. Ligand-receptor analysis and in vitro experiments suggest that Injury-like VS-SCs recruit myeloid cells via CSF1 signaling. Our study indicates that Injury-like SCs may cause tumor growth via myeloid cell recruitment and identifies molecular pathways that may be therapeutically targeted.
Topics: Humans; Neuroma, Acoustic; Ecosystem; Multiomics; Schwann Cells; Signal Transduction; Single-Cell Analysis; Tumor Microenvironment
PubMed: 38216553
DOI: 10.1038/s41467-023-42762-w -
Neurology India 2023Stereotactic radiosurgery (SRS) is an established modality of treatment for vestibular schwannomas (VS). We aim to summarize the evidence-based use of SRS in VSs and... (Review)
Review
Stereotactic radiosurgery (SRS) is an established modality of treatment for vestibular schwannomas (VS). We aim to summarize the evidence-based use of SRS in VSs and address the specific considerations pertaining to the same, along with our own clinical experiences. A thorough review of the literature was done to gather evidence regarding the safety and efficacy of SRS in VSs. Additionally, we have reviewed the senior author's experience in treating VSs (N = 294) between 2009 and 2021 and our experiences with microsurgery in post-SRS patients. Available scientific evidence upholds the role of SRS in VSs, in small-to-medium-sized tumors (5-year local tumor control >95%). The risk of adverse radiation effects remains minimal, while the hearing preservation rates are variable. Our center's post-GammaKnife VS follow-up cohort (sporadic - 157, neurofibromatosis-2 - 14) showed excellent tumor control rates at the last follow-up of 95.5% (sporadic) and 93.8% (neurofibromatosis-2), with a median margin dose of 13 Gy and mean follow-up periods of 3.6 (sporadic) and 5.2 (neurofibromatosis-2) years. Microsurgery in post-SRS VSs poses a formidable challenge due to the resulting thickened arachnoid and adhesions to critical neurovascular structures. Near-total excision is the key to better functional outcomes in such cases. SRS is here to stay as a trusted alternative in the management of VSs. Further studies are required to propose means of accurate prediction of hearing preservation rates and also to compare the relative efficacies of various SRS modalities.
Topics: Humans; Neuroma, Acoustic; Radiosurgery; Hearing Tests; Microsurgery; Neurofibromatoses; Treatment Outcome; Follow-Up Studies; Retrospective Studies
PubMed: 37026342
DOI: 10.4103/0028-3886.373653 -
The Journal of International Advanced... Jan 2023Few investigations have been conducted on the clinical characteristics of the differential diagnosis of acoustic neuroma with acute sensorineural hearing loss and...
BACKGROUND
Few investigations have been conducted on the clinical characteristics of the differential diagnosis of acoustic neuroma with acute sensorineural hearing loss and idiopathic sudden sensorineural hearing loss. The aim of the study was to investigate the clinical characteristics of the differential diagnoses between acoustic neuroma and idiopathic sudden sensorineural hearing loss.
METHODS
The medical records of patients with acute sensorineural hearing loss (142 ears), including acoustic neuroma (19 ears) and idiopathic sudden sensorineural hearing loss (123 ears), who underwent audiometric and hematologic examinations and received systemic corticosteroid treatment, were retrospectively reviewed.
RESULTS
Hematological examination revealed that the erythrocyte sedimentation rate and fibrinogen values were significantly higher in the idiopathic sudden sensorineural hearing loss group compared to the acoustic neuroma group. Although all patients received corticosteroid treatment, hearing thresholds at the initial examination and 3 months after corticosteroid treatment were significantly higher in the idiopathic sudden sensorineural hearing loss group compared to the acoustic neuroma group at all frequencies. However, hearing recovery was worse in the acoustic neuroma group compared to the idiopathic sudden sensorineural hearing loss group. Furthermore, speech discrimination and short increment sensitivity index tests were not significantly different between the acoustic neuroma and idiopathic sudden sensorineural hearing loss groups.
CONCLUSION
This is the first study to reveal that speech discrimination and short increment sensitivity index tests are not useful for the differential diagnoses between acoustic neuroma and idiopathic sudden sensorineural hearing loss, whereas erythrocyte sedimentation rate and fibrinogen, blood biomarkers of inflammation and blood viscosity, would be considered valuable. Furthermore, acoustic neuroma should be considered in cases where acute sensorineural hearing loss did not recover after corticosteroid treatment, although the initial hearing loss was mild.
Topics: Humans; Neuroma, Acoustic; Retrospective Studies; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Adrenal Cortex Hormones; Fibrinogen
PubMed: 36718029
DOI: 10.5152/iao.2023.22720 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... Jul 2022Vestibular schwannoma (VS) is one of the most common types of benign tumors of the central nervous system. At present, the prevailing treatment methods of VS include... (Review)
Review
Vestibular schwannoma (VS) is one of the most common types of benign tumors of the central nervous system. At present, the prevailing treatment methods of VS include surgery, stereotactic radiotherapy, and follow-up observation, etc. However, there is still no drug therapy available for treating VS. Although the surgical technique is relatively mature, the complications cannot be completely avoided. Furthermore, both the growth rate of different cases and patients' sensitivity to radiotherapy vary greatly. With the constant progress made in molecular biology research, most of the studies on the growth mechanism of VS focus on the upstream and downstream of neurofibromin 2 ( 2) gene and merlin protein, and a number of corresponding targets, including receptor protein tyrosine kinase (RTK), vascular endothelial growth factor receptor (VEGFR), mammalian target of rapamycin complex 1 (mTORC1) and platelet derived growth factor receptor (PDGFR). It has been reported in some studies that quite a few drugs could inhibit the proliferation of VS cells. Most of the studies are still in the stage of cell experiment and/or animal experiment. A small number of studies have entered phase Ⅰ and phase Ⅱ clinical trials, but have not led to any clinical treatment yet. This paper provides a comprehensive understanding of the current status and the prospects of drug therapies of VS, which is conducive to the development of subsequent research.
Topics: Animals; Mammals; Neurofibromin 2; Neuroma, Acoustic; Vascular Endothelial Growth Factor A
PubMed: 35871721
DOI: 10.12182/20220760202 -
Ugeskrift For Laeger Sep 2018Vestibular schwannomas are benign tumours originating from the eighth cranial nerve. The incidence in Denmark is rising and is around 200 per million per year. Pure tone... (Review)
Review
Vestibular schwannomas are benign tumours originating from the eighth cranial nerve. The incidence in Denmark is rising and is around 200 per million per year. Pure tone audiometry, discrimination score and tinnitus anamnesis determine, whether a diagnostic MRI is merited. Around one fourth of newly diagnosed patients receive surgery due to the size of the tumour, whereas the remaining three fourths go into a "wait-and-scan" regime. 30-40% of the patients in this regime experience growth and are offered either surgery or radiotherapy.
Topics: Algorithms; Humans; Magnetic Resonance Imaging; Neuroma, Acoustic; Watchful Waiting
PubMed: 30259833
DOI: No ID Found -
Acta Otorhinolaryngologica Italica :... Apr 2023translate and validate the Penn Acoustic Neuroma Quality of Life Scale into Italian language (PANQOL-It).
OBJECTIVE
translate and validate the Penn Acoustic Neuroma Quality of Life Scale into Italian language (PANQOL-It).
METHODS
the instrument was translated and psychometric properties were subsequently assessed by administering the PANQOL-It to 124 outpatients together with the Depression Anxiety Stress Scale (DASS21) and the Understanding and Communicating domain of the World Health Organization Disability Assessment Schedule II (WHODAS II-D1). The internal consistency, test-retest reliability, construct and criterion-related validity were assessed.
RESULTS
Cronbach's alpha coefficient was 0.92 for the total score and ranged from 0.44 to 0.90 in the seven domains. Significant test-retest reliability was observed (intraclass-correlation = 0.75; p < 0.01). Moderate correlation was reported between facial dysfunction domain and objective facial involvement (p < 0.01). Moderate to strong correlations were observed between anxiety, general health domains and all subscales of the DASS21, and between WHODAS II-D1 and general health and energy domains (p < 0.01). These latter results indicated good construct and criterion-related validity respectively.
CONCLUSIONS
PANQOL-It presented more than acceptable psychometric properties and its adoption is justified for both clinical and research purposes.
Topics: Humans; Neuroma, Acoustic; Quality of Life; Reproducibility of Results; Language; Italy; Surveys and Questionnaires
PubMed: 37099437
DOI: 10.14639/0392-100X-N2263