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Frontiers in Oncology 2021Health-related quality of life (HRQoL) and self-reported outcome measures have a relevant impact on the medical decision-making process. They capture either the current...
OBJECTIVE
Health-related quality of life (HRQoL) and self-reported outcome measures have a relevant impact on the medical decision-making process. They capture either the current status and allow for multiple prospective evaluations in the course of a treatment or rely on the retrospective comparison of health of patients before and after an intervention to assess its benefit. Importantly, these patient-assessed measures may be influenced by psychological factors. We compared HRQoL and perceived benefit in the course of surgical vestibular schwannoma (VS) treatment, as assessed by the patients from a prospective and retrospective point-of-view, and evaluated the influence of co-morbid depression.
METHODS
Within a prospective observational single-center study, forty-three patients with VS were investigated before and after retrosigmoid tumor resection. SF-36, Beck Depression Inventory and patient-assessed clinical symptoms were acquired before surgery and at follow-up. At follow-up, the Glasgow Benefit Inventory (GBI) was acquired as well.
RESULTS
SF-36 scores were significantly lower than the age and sex matched normative data in six and three out of eight categories before and after surgery, respectively. Three categories improved significantly after vs. before surgery; one of them (global health) reached a minimal clinical important difference. In contrast, patients reported predominantly a deterioration, when asked for a retrospective evaluation of the benefit (i.e., GBI). Depression correlated with both SF-36 and GBI, determined dissatisfaction, improved significantly after surgery and was the measure that had the largest impact on HRQoL.
CONCLUSION
Prospective and retrospective HRQoL measures may lead to different findings and can be confounded by psychological factors.
PubMed: 35223451
DOI: 10.3389/fonc.2021.770789 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Dec 2022To analyze the clinical characteristics of unilateral acoustic neuroma(AN) with normal hearing, so as to provide evidence for early identification AN. Clinical datas...
To analyze the clinical characteristics of unilateral acoustic neuroma(AN) with normal hearing, so as to provide evidence for early identification AN. Clinical datas from 73 patients of unilateral AN with normal hearing of Otorhinolaryngology Head and Neck Surgery of Beijing Tiantan Hospital affiliated of Capital Medical University from August 2019 to April 2022 admitted to department were retrospectively analyzed. All patients underwent pure tone audiometry(PTA), speech discrimination score(SDS), auditory brainstem response(ABR), distortion product otoacoustic emission(DPOAE) and head enhanced MRI. The incidence of normal hearing among patients with AN was 10.7%. Male∶female=1∶2.2; the mean age of the patients was(37.3±9.4) years; the mean tumor size was(24.2±11.2) mm. Tinnitus was the most common reason for visit; the patients who had headache and dizziness had larger tumors. Surgery was the main treatment, and the patients who underwent surgery had larger tumors than those of follow-up. Heterogeneous tumors were the most common type of MRI, homogeneous tumors were smaller than heterogeneous and cystic tumors. The sensitivity of ABR in the diagnosis of AN with normal hearing was 95.9%, and that of ≥20 mm tumors was 100%; prolonged Ⅴ-waves were the most common, patients with Ⅴ-wave deletion had larger tumors than those with normal or prolonged Ⅴ-waves. Patients who had the longer the Ⅴ-wave and the longer difference between Ⅰ-Ⅴ wave had larger tumors. DPOAE was not elicited at full frequency in 11 patients. There was no statistically significant difference in age among patients with different symptoms, treatments, types of MRI, ABR and DPOAE. AN of normal hearing was most common in 30-39 years old women. Patients had different symptoms, phenotypes of MRI and ABR. Patients with normal hearing who had tinnitus, dizziness, headache, facial paraesthesia, and recovery after sudden haring loss can be further examination of ABR and DPOAE for early identification AN. The sensitivity of ABR in diagnosis of hearing normal AN was 95.9%, and the abnormal type of Ⅴ-wave is related to tumor size.
Topics: Female; Humans; Tinnitus; Neuroma, Acoustic; Retrospective Studies; Dizziness; Auditory Threshold; Hearing; Evoked Potentials, Auditory, Brain Stem; Vertigo; Audiometry, Pure-Tone
PubMed: 36543395
DOI: 10.13201/j.issn.2096-7993.2022.12.002 -
European Journal of Epidemiology May 2022We investigated the association of allergic diseases and epilepsy with risk of brain tumours, in Interphone, a 13-country case-control study. Data were obtained from...
We investigated the association of allergic diseases and epilepsy with risk of brain tumours, in Interphone, a 13-country case-control study. Data were obtained from 2693 glioma cases, 2396 meningioma cases, and 1102 acoustic neuroma cases and their 6321 controls. Conditional logistic regression models were used to estimate pooled odds ratios (ORs) and their respective 95% confidence intervals (CIs), adjusted for education and time at interview. Reduced ORs were observed for glioma in relation to physician-diagnosed asthma (OR = 0.73; CI 0.58-0.92), hay fever (OR 0.72; CI 0.61-0.86), and eczema (OR 0.78, CI 0.64-0.94), but not for meningioma or acoustic neuroma. Previous diagnosis of epilepsy was associated with an increased OR for glioma (2.94; CI 1.87-4.63) and for meningioma (2.12; CI 1.27-3.56), but not for acoustic neuroma. This large-scale case-control study adds to the growing evidence that people with allergies have a lower risk of developing glioma, but not meningioma or acoustic neuroma. It also supports clinical observations of epilepsy prior to the diagnosis of glioma and meningioma.
Topics: Brain Neoplasms; Case-Control Studies; Epilepsy; Glioma; Humans; Hypersensitivity; Meningeal Neoplasms; Meningioma; Neuroma, Acoustic; Risk Factors
PubMed: 35118581
DOI: 10.1007/s10654-022-00843-y -
Science Advances Nov 2023Vestibular schwannoma (VS) is an intracranial tumor arising from neoplastic Schwann cells and typically presenting with hearing loss. The traditional belief that hearing...
Vestibular schwannoma (VS) is an intracranial tumor arising from neoplastic Schwann cells and typically presenting with hearing loss. The traditional belief that hearing deficit is caused by physical expansion of the VS, compressing the auditory nerve, does not explain the common clinical finding that patients with small tumors can have profound hearing loss, suggesting that tumor-secreted factors could influence hearing ability in VS patients. We conducted profiling of patients' plasma for 66 immune-related factors in patients with sporadic VS ( > 170) and identified and validated candidate biomarkers associated with tumor size (S100B) and hearing (MCP-3). We further identified a nine-biomarker panel (TNR-R2, MIF, CD30, MCP-3, IL-2R, BLC, TWEAK, eotaxin, and S100B) with outstanding discriminatory ability for VS. These findings revealed possible therapeutic targets for VS, providing a unique diagnostic tool that may predict hearing change and tumor growth in VS patients, and may inform the timing of tumor resection to preserve hearing.
Topics: Humans; Neuroma, Acoustic; Hearing Loss; Hearing; Biomarkers; Deafness
PubMed: 37948527
DOI: 10.1126/sciadv.adf7295 -
Mathematical Biosciences and... Apr 2023Prior to the surgical removal of an acoustic neuroma, the majority of patients anticipate that their hearing will be preserved to the greatest possible extent following...
Prior to the surgical removal of an acoustic neuroma, the majority of patients anticipate that their hearing will be preserved to the greatest possible extent following surgery. This paper proposes a postoperative hearing preservation prediction model for the characteristics of class-imbalanced hospital real data based on the extreme gradient boost tree (XGBoost). In order to eliminate sample imbalance, the synthetic minority oversampling technique (SMOTE) is applied to increase the number of underclass samples in the data. Multiple machine learning models are also used for the accurate prediction of surgical hearing preservation in acoustic neuroma patients. In comparison to research results from existing literature, the experimental results found the model proposed in this paper to be superior. In summary, the method this paper proposes can make a significant contribution to the development of personalized preoperative diagnosis and treatment plans for patients, leading to effective judgment for the hearing retention of patients with acoustic neuroma following surgery, a simplified long medical treatment process and saved medical resources.
Topics: Humans; Neuroma, Acoustic; Retrospective Studies; Hearing
PubMed: 37322959
DOI: 10.3934/mbe.2023477 -
Journal of Neurological Surgery. Part... Dec 2021Ipsilateral cochlear implantation (CI) in vestibular schwannoma (VS) has been an emerging trend over the last two decades. We conducted the first systematic review...
Ipsilateral cochlear implantation (CI) in vestibular schwannoma (VS) has been an emerging trend over the last two decades. We conducted the first systematic review of hearing outcomes comparing neurofibromatosis 2 (NF2) and sporadic VS undergoing CI. A comparison of the two populations and predictor of outcome was assessed. This is an update to a previously presented study. Systemic data searches were performed in PubMed NCBI and Scopus by an academic librarian. No restrictions based on the year of publication were used. Studies were selected if patients had a diagnosis of NF2 and a CI placed in the affected side with reports of hearing outcome. Two independent reviewers screened each abstract and full-text article. Studies were extracted at the patient level, and the assessment of quality and bias was evaluated according to the National Institutes of Health Quality Assessment Tool. Outcome predictors were determined by using the chi-square test and Student's -test. Overall, most CI recipients functioned in the high-to-intermediate performer category for both sporadic and NF2-related VS. Median AzBio (Arizona Biomedical Institute Sentence Test) was 72% (interquartile range [IQR]: 50) in NF2 patients and 70% (IQR: 7.25) in sporadic patients. Larger tumor size predicted a poorer final audiometric outcome. Categorization of hearing outcome into superior performance and inferior performance based on sentence recognition revealed a generally good hearing outcome regardless of treatment or patient population. Select patients with sporadic and NF2 VS may benefit from CI.
PubMed: 34745832
DOI: 10.1055/s-0040-1715606 -
Current Medical Science Apr 2023This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging (MRI) for...
Development and Validation of a Deep Learning Predictive Model Combining Clinical and Radiomic Features for Short-Term Postoperative Facial Nerve Function in Acoustic Neuroma Patients.
OBJECTIVE
This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging (MRI) for short-term postoperative facial nerve function in patients with acoustic neuroma.
METHODS
A total of 110 patients with acoustic neuroma who underwent surgery through the retrosigmoid sinus approach were included. Clinical data and raw features from four MRI sequences (T1-weighted, T2-weighted, T1-weighted contrast enhancement, and T2-weighted-Flair images) were analyzed. Spearman correlation analysis along with least absolute shrinkage and selection operator regression were used to screen combined clinical and radiomic features. Nomogram, machine learning, and convolutional neural network (CNN) models were constructed to predict the prognosis of facial nerve function on the seventh day after surgery. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate model performance. A total of 1050 radiomic parameters were extracted, from which 13 radiomic and 3 clinical features were selected.
RESULTS
The CNN model performed best among all prediction models in the test set with an area under the curve (AUC) of 0.89 (95% CI, 0.84-0.91).
CONCLUSION
CNN modeling that combines clinical and multi-sequence MRI radiomic features provides excellent performance for predicting short-term facial nerve function after surgery in patients with acoustic neuroma. As such, CNN modeling may serve as a potential decision-making tool for neurosurgery.
Topics: Humans; Deep Learning; Facial Nerve; Neuroma, Acoustic; Magnetic Resonance Imaging; Prognosis
PubMed: 37059936
DOI: 10.1007/s11596-023-2713-x -
Cureus Jan 2023Treatment of large vestibular schwannoma (VS) has historically centered on total resection of the lesion. Staged surgery has been used for VS that is highly...
Treatment of large vestibular schwannoma (VS) has historically centered on total resection of the lesion. Staged surgery has been used for VS that is highly vascularized, unexpected events during surgery, and thinned and stretched facial nerve with serious adherence causing difficult dissection. We present a case of a patient with a large VS resected through a two-stage surgery through the same retrosigmoid craniotomy.
PubMed: 36779147
DOI: 10.7759/cureus.33552 -
Surgical Neurology International 2022Since its introduction to surgery, the CO laser has been used in the treatment of various neurosurgical pathologies as it combines cutting, vaporizing, and coagulating...
BACKGROUND
Since its introduction to surgery, the CO laser has been used in the treatment of various neurosurgical pathologies as it combines cutting, vaporizing, and coagulating properties in one tool and has a safe penetration depth. In this case series of 29 patients, we present the evaluation of the usefulness of the closed system type - sealed tube surgical CO laser in the surgical removal of brain tumors.
METHODS
The Sharplan 40C model SurgiTouch, sealed tube type CO laser, was used in the resection of 29 brain tumors; 13 meningiomas, six metastases, nine gliomas, and one acoustic neuroma. The same senior surgeon (BT) assessed and classified the benefit provided by the CO laser in the resection of the neoplasms to considerable (Group 1), moderate (Group 2), and poor (Group 3).
RESULTS
Group 1 included 14 patients with 13 meningiomas and one acoustic neuroma, Group 2 included six patients, all of whom had metastases, and Group 3 included nine patients of which six had glioblastoma and three astrocytoma. No complications or technical problems occurred due to the use of the CO laser.
CONCLUSION
The CO laser is a valuable complementary tool in brain tumor surgery displaying high efficacy and practicality in the resection of neoplasms which are fibrous and have hard consistency. It has high acquisition and maintenance cost and cannot replace the bipolar diathermy. The newest generation of flexible CO laser fiber provides more ergonomy and promises new perspectives of its neurosurgical use in the modern era.
PubMed: 35509540
DOI: 10.25259/SNI_158_2022 -
American Journal of Translational... 2023Vestibular schwannoma is the most common benign tumor in the pontocerebellar horn region. As the tumor grows, it often causes severe hearing loss due to compression of...
BACKGROUND
Vestibular schwannoma is the most common benign tumor in the pontocerebellar horn region. As the tumor grows, it often causes severe hearing loss due to compression of nearby nerves, resulting in a lower quality of life. This study examined vestibular schwannoma-related research through a bibliometric and visualization analysis, and it explored current trends and research hot spots.
METHODS
Research related to vestibular schwannoma published from 2002 to 2021 was searched using the Web of Science Core Collection. The processing and visualization analysis of the data were conducted using R software, VOSviewer, and CiteSpace.
RESULTS
A total of 3,909 publications were included in this study, and an overall increasing trend in the annual output of publications was found. The United States, Germany, and the United Kingdom were the most prolific countries, publishing the most articles. Germany had the most frequent international cooperation and the highest centrality score. The Mayo Clinic, University of California, and Harvard University were the three most productive institutions. was the most prolific journal, and MJ Link was the most productive and highest scoring author for centrality. Current frontier topics mainly focused on "hearing preservation" and "radiosurgery". A map of trends in topics and a thematic graph revealed that "hearing loss", "vertigo", "magnetic resonance imaging", "radiosurgery", "stereotactic radiosurgery", and "gamma knife" were the topics of focus of current discussions.
CONCLUSION
Hearing preservation is a current frontier topic in this area. Radiosurgery has a promising future in the field of vestibular schwannoma, and stereotactic radiosurgery is a focus of global attention. Bibliometric and visualization analysis offer a unique and objective perspective of the field of vestibular schwannoma and may assist scholars in the identification of new research directions.
PubMed: 36915774
DOI: No ID Found