Risk Factors of Acoustic Neuroma: Systematic Review and Meta-Analysis

Abstract

PurposeMany epidemiological studies have investigated environmental risk factors for the development of acoustic neuroma. However, these results are controversial. We conducted a meta-analysis of case-control studies to identify any potential relationship between history of noise exposure, smoking, allergic diseases, and risk of acoustic neuroma.Materials and MethodsWe searched PubMed to identify relevant articles. Two researchers evaluated the eligibility and extracted the data independently.ResultsEleven case-control studies were included in our meta-analysis. Acoustic neuroma was found to be associated with leisure noise exposure [odds ratio (OR)=1.33, 95% confidence interval (CI): 1.05–1.68], but not with occupational noise exposure and ever noise exposure (OR=1.20, 95% CI: 0.84–1.72 and OR=1.15, 95% CI: 0.80–1.65). The OR of acoustic neuroma for ever (versus never) smoking was 0.53 (95% CI: 0.30–0.94), while the subgroup analysis indicated ORs of 0.95 (95% CI: 0.81–1.10) and 0.49 (95% CI: 0.41–0.59) for ex-smoker and current smoker respectively. The ORs for asthma, eczema, and seasonal rhinitis were 0.98 (95% CI: 0.80–1.18), 0.91 (95% CI: 0.76–1.09), and 1.52 (95% CI: 0.90–2.54), respectively.ConclusionOur meta-analysis is suggestive of an elevated risk of acoustic neuroma among individuals who were ever exposed to leisure noise, but not to occupational noise. Our study also indicated a lower acoustic neuroma risk among ever and current cigarette smokers than never smokers, while there was no significant relationship for ex-smokers. No significant associations were found between acoustic neuroma and history of any allergic diseases, such as asthma, eczema, and seasonal rhinitis.

Clinical Analysis of small Acoustic neuromas With Initial Neurological Symptoms

“…Acoustic neuromas are the most common type of tumor in the region of the internal auditory canal with a higher prevalence in females than in males [3] . Our study found the same trend, with a larger prevalence of ANs in women (n = 59.1%) than in men (n = 40.9%).…”

“…Acoustic neuromas (ANs), or vestibular schwannomas, which were first identified in 1777 by Eduard Sandifort [1] , represent a type of benign brain tumor of Schwann cells that mostly arises from the vestibular nerve [2] . ANs represent one of the most common intracranial tumors with an incidence from 1 to 20 per million, and ANs accounts for approximately 6% of all intracranial tumors [3] .…”

Manifestação clínica-epidemiológica do Schwannoma vestibular

“…Porém, já existem estudos que associam a forma esporádica com exposição à radiação e exposição ocupacional aofumo de tabaco e mercúrio 3 . Não há relação significativa entre o SV e os processos alérgicos, uso de drogas anti-histamínicas, traumatismo craniano, trauma acústico ou outras doenças neoplásicas 7 .…”

Radiation Therapy in Acoustic Neuroma

“…For the unilateral presentation, the median age at diagnosis is 50 years, with a gender ratio (F:M) greater than 1. A bilateral vestibular schwannoma is pathognomonic of neurofibromatosis type 2 (NF2) and occurs in younger age, typically at 10-20 years (Chen et al 2016).…”

“…-Childhood exposure to ionizing radiation due to medical treatment or extraordinary events (i. e., atomic explosions) (Schneider et al 2008); -Exposure to electromagnetic fields; a recent meta-analysis reported a significantly higher risk for any type of intracranial tumor after use of mobile phone over 10 years (odds ratio (OR) = 1.3, 95% confidence interval (CI): 1.028-1.704) (Bortkiewicz et al 2017); -Noise exposure; a meta-analysis published in 2016 suggests an elevated risk for acoustic neuroma in individuals who were ever exposed to leisure noise (OR = 1.3, 95%CI: 1.05-1.68), but not to occupational noise (OR = 1.2, 95% CI: 0.84-1.72) (Chen et al 2016).…”