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Brazilian Journal of Otorhinolaryngology 2009The vestibulocochlear nerve schwannoma (VS) is a benign tumor that stems from the edge of the Schwann s sheath. It is considered the most frequent intracranial benign... (Review)
Review
UNLABELLED
The vestibulocochlear nerve schwannoma (VS) is a benign tumor that stems from the edge of the Schwann s sheath. It is considered the most frequent intracranial benign tumor, of low lethality rate and unknown etiology.
AIM
to identify risk factors associated with VS.
STUDY DESIGN
systematic review.
METHODS
electronic search of studies using the following key words: 'risk', 'schwannoma', 'vestibular', 'neuroma' and 'acoustic'. All original articles on epidemiological studies published in Portuguese, English or Spanish describing measures of association were included.
RESULTS
twenty case-control studies were found, most of them published in the United States. The analysis of those studies shows educational level, household income, occupation, exposure to ionizing radiation and noise, allergic diseases as well as the use of both cellular and cordless phones as risk factors for the VS.
CONCLUSION
methodological limitations and lack of precision in the findings impose limits to definitive conclusions concerning those risk factors. The current study contributes with information which can subsidize decisions related to the methodology to be used, having in mind new investigations on risk factors for VS. Therefore, it is of great help for knowledge improvement in this field.
Topics: Adult; Environmental Exposure; Female; Humans; Male; Middle Aged; Neuroma, Acoustic; Risk Factors; Time Factors
PubMed: 19784431
DOI: 10.1016/s1808-8694(15)30501-2 -
Brazilian Journal of Otorhinolaryngology 2008Telecommunications systems emit radiofrequency, which is an invisible electromagnetic radiation. Mobile phones operate with microwaves (450900 MHz in the analog service,... (Review)
Review
UNLABELLED
Telecommunications systems emit radiofrequency, which is an invisible electromagnetic radiation. Mobile phones operate with microwaves (450900 MHz in the analog service, and 1,82,2 GHz in the digital service) very close to the users ear. The skin, inner ear, cochlear nerve and the temporal lobe surface absorb the radiofrequency energy.
AIM
literature review on the influence of cellular phones on hearing and balance.
STUDY DESIGN
systematic review.
METHODS
We reviewed papers on the influence of mobile phones on auditory and vestibular systems from Lilacs and Medline databases, published from 2000 to 2005, and also materials available in the Internet.
RESULTS
Studies concerning mobile phone radiation and risk of developing an acoustic neuroma have controversial results. Some authors did not see evidences of a higher risk of tumor development in mobile phone users, while others report that usage of analog cellular phones for ten or more years increase the risk of developing the tumor. Acute exposure to mobile phone microwaves do not influence the cochlear outer hair cells function in vivo and in vitro, the cochlear nerve electrical properties nor the vestibular system physiology in humans. Analog hearing aids are more susceptible to the electromagnetic interference caused by digital mobile phones.
CONCLUSION
there is no evidence of cochleo-vestibular lesion caused by cellular phones.
Topics: Animals; Auditory Perceptual Disorders; Cell Phone; Electromagnetic Fields; Humans; Neuroma, Acoustic; Otoacoustic Emissions, Spontaneous; Rats; Risk Factors; Time Factors; Vestibule, Labyrinth
PubMed: 18392513
DOI: 10.1016/s1808-8694(15)30762-x -
Neuro-oncology Practice Dec 2021Differences in long-term outcomes of single-fraction stereotactic radiosurgery (SRS) between gamma knife (GK) and linear accelerator (LINAC) systems for vestibular... (Review)
Review
BACKGROUND
Differences in long-term outcomes of single-fraction stereotactic radiosurgery (SRS) between gamma knife (GK) and linear accelerator (LINAC) systems for vestibular schwannoma (VS) management remain unclear. To investigate differences in safety and efficacy between modalities, we conducted a meta-analysis of studies over the past decade.
METHODS
MEDLINE, EMBASE, and Cochrane databases were queried for studies with the following inclusion criteria: English language, published between January 2010 and April 2020, cohort size ≥30, and mean/median follow-up ≥5 years. Odds ratios (OR) compared rates of tumor control, hearing preservation, and cranial nerve toxicities before and after SRS.
RESULTS
Thirty-nine studies were included (29 GK, 10 LINAC) with 6516 total patients. Tumor control rates were 93% (95% CI 91-94%) and 94% (95% CI 91-97%) for GK and LINAC, respectively. Both GK (OR 0.06, 95% CI 0.02-0.13) and LINAC (OR 0.47, 95% CI 0.29-0.76) reduced odds of serviceable hearing. Neither GK (OR 0.71, 95% CI 0.41-1.22) nor LINAC (OR 1.13, 95% CI 0.64-2.00) impacted facial nerve function. GK decreased odds of trigeminal nerve (TN) impairment (OR 0.55, 95% CI 0.32-0.94) while LINAC did not impact TN function (OR 1.45, 95% CI 0.81-2.61). Lastly, LINAC offered decreased odds of tinnitus (OR 0.15, 95% CI 0.03-0.87) not observed with GK (OR 0.70, 95% CI 0.48-1.01).
CONCLUSIONS
VS tumor control and hearing preservation rates are comparable between GK and LINAC SRS. GK may better preserve TN function, while LINAC decreases tinnitus rates. Future studies are warranted to investigate the efficacy of GK and LINAC SRS more directly.
PubMed: 34777833
DOI: 10.1093/nop/npab052 -
Stereotactic and Functional Neurosurgery 2021Trigeminal neuralgia (TN) secondary to tumors is encountered in up to 6% of patients with facial pain syndromes and is considered to be associated with tumors affecting... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Trigeminal neuralgia (TN) secondary to tumors is encountered in up to 6% of patients with facial pain syndromes and is considered to be associated with tumors affecting the trigeminal nerve pathways. The most frequent are meningiomas and vestibular schwannomas (VS). Stereotactic radiosurgery (SRS) has emerged as a valuable treatment, with heterogeneity of clinical results. We sought to review the medical literature on TN treated with SRS for meningiomas and VS and investigate the rates of improvement of TN symptoms.
METHODS
We reviewed articles published between January 1990 and December 2019 in PubMed. Pain relief after SRS, the maintenance of pain relief, and TN recurrence and complications were evaluated with separate meta-analyses, taking into account the data on individual patients.
RESULTS
Pain relief after SRS was reported as Barrow Neurological Institute (BNI) pain intensity scores of BNI I in 50.5% (range 36-65.1%) of patients and BNI I-IIIb in 83.8% (range 77.8-89.8%). There was no significant difference in series discussing outcomes for tumor targeting versus tumor and nerve targeting. Recurrences were described in 34.7% (range 21.7-47.6; tumor targeting). Maintenance of BNI I was reported in 36.4% (range 20.1-52.7) and BNI I-IIIb in 41.2% (range 29.8-52.7; tumor targeting series). When both the nerve and the tumor were targeted, only 1 series reported 86.7% with BNI I-IIIb at last follow-up. Complications were encountered in 12.6% (range 6.3-18.8; tumor targeting series) of patients; however, they were much higher, as high as 26.7%, in the only study reporting them after targeting both the nerve and the tumor. The most common complication was facial numbness.
CONCLUSION
SRS for TNB secondary to benign tumors, such as meningiomas and VS, is associated with favorable clinical course, but less favorable than in idiopathic TN. There was, however, heterogeneity among reports and targeting approaches. Although targeting both the nerve and the tumor seemed to achieve better long-term results, the rate of complications was much higher and the number of patients treated was limited. Future clinical studies should focus on the standard reporting of clinical outcomes and randomization of targeting methods.
Topics: Humans; Meningeal Neoplasms; Meningioma; Neuroma, Acoustic; Pain Management; Radiosurgery; Retrospective Studies; Treatment Outcome; Trigeminal Neuralgia
PubMed: 32906130
DOI: 10.1159/000509842 -
Otolaryngology--head and Neck Surgery :... Nov 2015The auditory brainstem implant (ABI) was initially developed for patients with deafness as a result of neurofibromatosis type 2. ABI indications have recently extended... (Review)
Review
OBJECTIVE
The auditory brainstem implant (ABI) was initially developed for patients with deafness as a result of neurofibromatosis type 2. ABI indications have recently extended to children with congenital deafness who are not cochlear implant candidates. Few multi-institutional outcome data exist. Herein, we aim to provide a systematic review of outcomes following implantation of the ABI in pediatric patients with nontumor diagnosis, with a focus on audiometric outcomes.
DATA SOURCES
PubMed, Embase, and Cochrane.
REVIEW METHODS
A systematic review of literature was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations. Variables assessed included age at implantation, diagnosis, medical history, cochlear implant history, radiographic findings, ABI device implanted, surgical approach, complications, side effects, and auditory outcomes.
RESULTS
The initial search identified 304 articles; 21 met inclusion criteria for a total of 162 children. The majority of these patients had cochlear nerve aplasia (63.6%, 103 of 162). Cerebrospinal fluid leak occurred in up to 8.5% of cases. Audiometric outcomes improved over time. After 5 years, almost 50% of patients reached Categories of Auditory Performance scores >4; however, patients with nonauditory disabilities did not demonstrate a similar increase in scores.
CONCLUSION
ABI surgery is a reasonable option for the habilitation of deaf children who are not cochlear implant candidates. Although improvement in Categories of Auditory Performance scores was seen across studies, pediatric ABI users with nonauditory disabilities have inferior audiometric outcomes.
Topics: Auditory Brain Stem Implants; Child; Deafness; Humans; Neurofibromatosis 2; Speech Perception; Treatment Outcome
PubMed: 26227469
DOI: 10.1177/0194599815596929 -
International Journal of Pediatric... May 2013To elucidate the otological manifestations found in this increasingly commonly diagnosed condition. This paper will discuss the diagnosis, aetiology, pathogenesis,... (Review)
Review
OBJECTIVES
To elucidate the otological manifestations found in this increasingly commonly diagnosed condition. This paper will discuss the diagnosis, aetiology, pathogenesis, management and the outcomes of treatment.
STUDY DESIGN
Systematic literature review.
MATERIALS AND METHODS
The following databases were searched for articles pertaining to the otological manifestations of autistic spectrum disorders: MEDLINE, EMBASE, CURRENT CONTENTS, PSYCHLIT, CINAHL and HEALTHSTAR. Articles from 1965 to June 2012 were extracted. Relevant articles from the literature were selected and reviewed by two independent authors. Each paper was assessed as to its level of evidence and validity. The relevant results are presented and discussed in order to present a practical approach to the management of these patients.
RESULTS
Patients with ASD have an increased incidence of peripheral and central otological pathology. This pathology plays a key role in the behavioural, communication, and social aspects of the disease. ASD patients have a higher incidence of profound sensorineural hearing loss, middle ear infections, and abnormalities of the cochlear nerve and brainstem auditory pathways. There are cortical and brainstem neurodevelopmental abnormalities in the way auditory information is interpreted and processed in the ASD patient.
CONCLUSIONS
The otolaryngologist plays a key role in the multidisciplinary management of individuals with ASD due to the high prevalence of otological pathology amongst these patients. Early diagnosis and expedient treatment focusing on normalisation of auditory input and development can maximise developmental outcomes.
Topics: Child; Child Development Disorders, Pervasive; Cochlear Implantation; Early Intervention, Educational; Hearing Disorders; Humans
PubMed: 23541959
DOI: 10.1016/j.ijporl.2013.02.006 -
Audiology Research Dec 2022With the recent scientific and technical developments, hearing preservation surgery is becoming a growing objective in inner ear pathologies, especially for vestibular... (Review)
Review
With the recent scientific and technical developments, hearing preservation surgery is becoming a growing objective in inner ear pathologies, especially for vestibular schwannomas. In this review, we aim to describe the pros and cons of the following cochlear nerve monitoring techniques: ABRs (auditory brainstem responses), DENM (direct eighth cranial nerve monitoring), EcochG (electrocochleography), CNAP (cochlear compound nerve action potentials), DPOAE (distortion product otoacoustic emissions), PAMRs (postauricular muscle responses). The Cochrane library, Scopus, DynaMed, and PubMed databases were screened to obtain any relevant papers from October 2009 to the present day. Due to the heterogeneity of the existing studies in the literature, there is no way to tell whether a technique is better than another. All authors reported satisfactory outcomes with the cochlear nerve monitoring techniques tested, either alone or in combination.
PubMed: 36546907
DOI: 10.3390/audiolres12060066 -
Otolaryngology--head and Neck Surgery :... May 2017Objective (1) To analyze reported speech perception outcomes in patients with inner ear malformations who undergo cochlear implantation, (2) to review the surgical... (Meta-Analysis)
Meta-Analysis Review
Objective (1) To analyze reported speech perception outcomes in patients with inner ear malformations who undergo cochlear implantation, (2) to review the surgical complications and findings, and (3) to compare the 2 classification systems of Jackler and Sennaroglu. Data Sources PubMed, Scopus (including Embase), Medline, and CINAHL Plus. Review Methods Fifty-nine articles were included that contained speech perception and/or intraoperative data. Cases were differentiated depending on whether the Jackler or Sennaroglu malformation classification was used. A meta-analysis of proportions examined incidences of complete insertion, gusher, and facial nerve aberrancy. For speech perception data, weighted means and standard deviations were calculated for all malformations for short-, medium-, and long-term follow-up. Speech tests were grouped into 3 categories-closed-set words, open-set words, and open-set sentences-and then compared through a comparison-of-means t test. Results Complete insertion was seen in 81.8% of all inner ear malformations (95% CI: 72.6-89.5); gusher was reported in 39.1% of cases (95% CI: 30.3-48.2); and facial nerve anomalies were encountered in 34.4% (95% CI: 20.1-50.3). Significant improvements in average performance were seen for closed- and open-set tests across all malformation types at 12 months postoperatively. Conclusions Cochlear implantation outcomes are favorable for those with inner ear malformations from a surgical and speech outcome standpoint. Accurate classification of anatomic malformations, as well as standardization of postimplantation speech outcomes, is necessary to improve understanding of the impact of implantation in this difficult patient population.
Topics: Child, Preschool; Cochlea; Cochlear Implantation; Cochlear Implants; Congenital Abnormalities; Ear, Inner; Female; Follow-Up Studies; Humans; Infant; Intraoperative Complications; Male; Risk Assessment; Speech Perception; Speech Production Measurement; Time Factors; Treatment Outcome
PubMed: 28374626
DOI: 10.1177/0194599817696502 -
The Journal of International Advanced... Jun 2023The aim of our study was to report rates of facial nerve palsy and residual tumor following surgical intervention and subsequent tumor recurrence in patients with... (Meta-Analysis)
Meta-Analysis
The aim of our study was to report rates of facial nerve palsy and residual tumor following surgical intervention and subsequent tumor recurrence in patients with endolymphatic sac tumors. A systematic literature review of preoperative assessment and surgical management is also included. Studies including patient/s affected by sporadic or von Hippel-Lindau disease related endolymphatic sac tumors, reporting levels of facial nerve function, residual and recurrence pathology following a surgical procedure, were considered. Data were combined for proportional meta-analysis, and the selected studies' methodological quality was also evaluated. Overall 34 papers, including 202 subjects (209 cases of endolymphatic sac tumors) were analyzed. Pooled proportion rate (95% CI) of overall facial nerve palsy was 39.7% (28.2-51.9) and residual tumor was 16.5% (10.3-23.7) after surgical procedure. Pooled proportion rate (95% CI) of tumor recurrence was 14.0% (9.7-19.3) during a mean follow-up period of 49.7 months (8-136). Our results showed that preoperative facial nerve function is impaired in almost 30% of patients with endolymphatic sac tumors. Surgical management of endolymphatic sac tumor may cause a worsening of facial nerve function in a low percentage of treated subjects. Residual and/or recurrence of endolymphatic sac tumors are not rare events, and follow-up strategies should be designed accordingly.
Topics: Humans; Endolymphatic Sac; Neoplasm Recurrence, Local; Neoplasm, Residual; von Hippel-Lindau Disease; Ear Neoplasms; Bone Neoplasms; Facial Paralysis
PubMed: 37272644
DOI: 10.5152/iao.2023.22957 -
Medicina (Kaunas, Lithuania) Sep 2023Transcutaneous electrical nerve stimulation (TENS), a pain-alleviating and muscle-relaxing treatment used in physio-therapeutic clinical practice, has recently appeared... (Review)
Review
Transcutaneous electrical nerve stimulation (TENS), a pain-alleviating and muscle-relaxing treatment used in physio-therapeutic clinical practice, has recently appeared to be just as effective in dysphonia. This review aimed at clarifying whether TENS can be an effective practice in dysphonia therapy and/or management on its own or combined with other types of interventions and, hence, whether its practice can be a useful, more widespread establishment to speech and language therapy intervention methods. A search was conducted on the PubMed database using specific terms based on the PICO search strategy. Eventually, four randomized controlled studies and four clinical trials were included. The methodological quality of the included studies was evaluated using the physiotherapy evidence-based database (PEDro) assessment tool, and this indicated high-quality research with an average score of 8.43. The studies utilized various TENS devices, predominantly the Dualpex 961 device (frequency of 10 Hz, phase of 200 ms). The assessment methods varied, including auditory perception, vocal therapy, electrostimulation, audio and video perceptual assessments, and laryngeal evaluations. The clinical outcomes of TENS showed a reduction in musculoskeletal pain in various areas, while the acoustic analysis results were significant in only one study. TENS was compared to manual laryngeal therapy (LMT), placebo TENS, and vocal therapy in different studies with mixed results. This review supports the idea that a multidimensional approach, incorporating various therapeutic modalities (TENS, LMT, speech therapy, and vocal training) can yield positive outcomes for patients with voice disorders. Further research is needed to explore the specific mechanisms of action and optimal treatment protocols for TENS in voice therapy.
Topics: Humans; Transcutaneous Electric Nerve Stimulation; Dysphonia; Musculoskeletal Pain; Treatment Outcome
PubMed: 37893455
DOI: 10.3390/medicina59101737