Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Các triệu chứng thính giác - tiền đình và chức năng thần kinh mặt so với phẫu thuật vi phẫu và SRS cho các u schwann của dây thần kinh tiền đình: một đánh giá hệ thống và phân tích tổng hợp
Tóm tắt
Phẫu thuật và xạ phẫu (SRS) là những lựa chọn điều trị phổ biến nhất cho u schwann của dây thần kinh tiền đình. Một đánh giá hệ thống và phân tích tổng hợp đã được thực hiện để so sánh kết quả giữa phẫu thuật và xạ phẫu định vị (SRS). Thư viện Cochrane, PubMed, Embase và clinicaltrials.gov đã được tìm kiếm cho đến tháng 01/2021 để tìm tất cả các nghiên cứu về các phương pháp phẫu thuật và xạ phẫu đã được thực hiện để điều trị u schwann của dây thần kinh tiền đình. Sử dụng mô hình ngẫu nhiên, các tỷ lệ nguy cơ gộp (OR) và khoảng tin cậy 95% (CI) so sánh giữa hậu phẫu và trước can thiệp đã được tính toán cho các nghiên cứu tiền - hậu, và tỷ lệ tai biến gộp trong giai đoạn hậu phẫu đã được tính cho các chuỗi trường hợp và phân loại theo loại can thiệp. Hai mươi mốt nghiên cứu (18 thiết kế tiền - hậu; ba chuỗi trường hợp) với 987 bệnh nhân đã được đưa vào phân tích cuối cùng. So sánh giữa hậu phẫu và trước can thiệp, cả phẫu thuật (OR: 3.52, 95%CI 2.13, 5.81) và SRS (OR: 3.30, 95%CI 1.39, 7.80) đều có tỷ lệ mất thính lực cao hơn, tỷ lệ chóng mặt thấp hơn (phẫu thuật OR: 0.10; 95%CI 0.02, 0.47 so với SRS OR: 0.22; 95%CI 0.05, 0.99) và triệu chứng ù tai (phẫu thuật OR: 0.23; 95%CI 0.00, 37.9; hai nghiên cứu so với SRS OR: 0.11; 95%CI 0.01, 1.07; một nghiên cứu). Tỷ lệ gộp mất đối xứng mặt cao hơn sau phẫu thuật (14.3%, 95%CI 6.8%, 22.7%) so với sau SRS (7%, 95%CI 1%, 36%). Kiểm soát khối u cao hơn ở nhóm phẫu thuật (94%, 95%CI 83%, 98%) so với nhóm SRS (80%, 95%CI 31%, 97%) đối với các khối u có kích thước nhỏ đến trung bình. Cả phẫu thuật và SRS đều cho kết quả tương tự về tỷ lệ mất thính lực và cải thiện triệu chứng chóng mặt cũng như ù tai ở những bệnh nhân mắc u schwann của dây thần kinh tiền đình; tuy nhiên, tỷ lệ mất đối xứng mặt dường như cao hơn sau phẫu thuật.
Từ khóa
#u schwann #phẫu thuật #xạ phẫu định vị #triệu chứng thính giác #chức năng thần kinh mặt #phân tích tổng hợpTài liệu tham khảo
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