Sex Differences in Vestibular Schwannoma

Machetanz, Kathrin; Wang, Sophie S.; Oberle, Linda; Tatagiba, Marcos; Naros, Georgios

doi:10.3390/cancers15174365

Cited by 3 publications

(1 citation statement)

References 48 publications

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“…They found no significant association between the surgical approach and tinnitus outcomes; however, female gender and tumor size >15 mm were found to be independent factors associated with good tinnitus outcomes [ 33 ]. This is in line with prior studies which have indicated sex differences in patients with VS [ 36 ].…”

Section: Resultssupporting

confidence: 93%

Vestibular Schwannoma and Tinnitus: A Systematic Review of Microsurgery Compared to Gamma Knife Radiosurgery

King,

Cooper,

Oganezova

et al. 2024

JCM

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Background: Vestibular schwannoma (VS) is a benign tumor of the eighth cranial nerve formed from neoplastic Schwann cells. Although VS can cause a variety of symptoms, tinnitus is one of the most distressing symptoms for patients and can greatly impact quality of life. The objective of this systematic review is to comprehensively examine and compare the outcomes related to tinnitus in patients undergoing treatment for VS. Specifically, it evaluates patient experiences with tinnitus following the removal of VS using the various surgical approaches of traditional surgical resection and gamma knife radiosurgery (GKS). By delving into various aspects such as the severity of tinnitus post-treatment, the duration of symptom relief, patient quality of life, new onset of tinnitus after VS treatment, and any potential complications or side effects, this review aims to provide a detailed analysis of VS treatment on tinnitus outcomes. Methods: Following PRISMA guidelines, articles were included from PubMed, Science Direct, Scopus, and EMBASE. Quality assessment and risk of bias analysis were performed using a ROBINS-I tool. Results: Although VS-associated tinnitus is variable in its intensity and persistence post-resection, there was a trend towards a decreased tinnitus burden in patients. Irrespective of the surgical approach or the treatment with GKS, there were cases of persistent or worsened tinnitus within the studied cohorts. Conclusion: The findings of this systematic review highlight the complex relationship between VS resection and tinnitus outcomes. These findings underscore the need for individualized patient counseling and tailored treatment approaches in managing VS-associated tinnitus. The findings of this systematic review may help in guiding clinicians towards making more informed and personalized healthcare decisions. Further studies must be completed to fill gaps in the current literature.

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Section: Resultssupporting

confidence: 93%

Vestibular Schwannoma and Tinnitus: A Systematic Review of Microsurgery Compared to Gamma Knife Radiosurgery

King,

Cooper,

Oganezova

et al. 2024

JCM

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Individual- and Community-Level Social Determinant Associations With Acoustic Neuroma Disparities in the United States

Fei-Zhang,

Sethia,

Abrahamson

et al. 2024

Otol Neurotol

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Objective This investigation aims to determine whether community-level social determinants of health (SDoH) influenced acoustic neuroma outcomes more profoundly than individual-level SDoH through the use of multivariate models and census-level socioeconomic status (SES) measures. Study Design Observational, retrospective cohort study. Setting: Specially Authorized Head–Neck SEER 2020 Dataset. Patients 23,330 adult (20+ yr) patients diagnosed with acoustic neuroma from 2010 to 2018. Main outcome measures Age-adjusted multivariate regressions and hazard models were performed for individual level (sex, race–ethnicity) and community-level factors (Yost Index–SES, rurality–urbanicity) to assess for differences in acoustic neuroma treatment, including delay of intervention, treatment receipt, and overall survival. Results Lower Yost–SES/community-level SES had a markedly positive association with an increase in all-cause mortality (HR, 1.55; 95% CI, 1.41–1.71) and negative association with stereotactic radiotherapy treatment (OR, 0.93; 95% CI, 0.86–0.99; p = 0.040). Patients with poor Yost–SES had a significantly positive association with receipt of surgical resection (OR, 1.13; 95% CI, 1.07–1.20; p < 0.001). Conclusions Data generated from this investigation suggest that community-level SDoH, particularly Yost–SES, have more detrimental care and prognostic disparities in acoustic neuroma treatment compared with individual-level factors.

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Innovative approaches for managing patients with chronic vestibular disorders: follow-up indicators and predictive markers for studying the vestibular error signal

Xavier,

Chouin,

Tighilet

et al. 2024

Front. Rehabil. Sci.

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IntroductionDespite significant advancements in understanding the biochemical, anatomical, and functional impacts of vestibular lesions, developing standardized and effective rehabilitation strategies for patients unresponsive to conventional therapies remains a challenge. Chronic vestibular disorders, characterized by permanent or recurrent imbalances and blurred vision or oscillopsia, present significant complexity in non-pharmacological management. The complex interaction between peripheral vestibular damage and its impact on the central nervous system (CNS) raises questions about neuroplasticity and vestibular compensation capacity. Although fundamental research has examined the consequences of lesions on the vestibular system, the effect of a chronic peripheral vestibular error signal (VES) on the CNS remains underexplored. The VES refers to the discrepancy between sensory expectations and perceptions of the vestibular system has been clarified through recent engineering studies. This deeper understanding of VES is crucial not only for vestibular physiology and pathology but also for designing effective measures and methods of vestibular rehabilitation, shedding light on the importance of compensation mechanisms and sensory integration.MethodsThis retrospective study, targeting patients with chronic unilateral peripheral vestibulopathy unresponsive to standard treatments, sought to exclude any interference from pre-existing conditions. Participants were evaluated before and after a integrative vestibular exploratory and rehabilitation program through questionnaires, posturographic tests, and videonystagmography.ResultsThe results indicate significant improvements in postural stability and quality of life, demonstrating positive modulation of the CNS and an improvement of vestibular compensation.DiscussionSuccessful vestibular rehabilitation likely requires a multifaceted approach that incorporates the latest insights into neuroplasticity and sensory integration, tailored to the specific needs and clinical progression of each patient. Focusing on compensating for the VES and enhancing sensory-perceptual-motor integration, this approach aims not just to tailor interventions but also to reinforce coherence among the vestibular, visual, and neurological systems, thereby improving the quality of life for individuals with chronic vestibular disorders.

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Sex Differences in Vestibular Schwannoma

Cited by 3 publications

References 48 publications

Vestibular Schwannoma and Tinnitus: A Systematic Review of Microsurgery Compared to Gamma Knife Radiosurgery

Vestibular Schwannoma and Tinnitus: A Systematic Review of Microsurgery Compared to Gamma Knife Radiosurgery

Individual- and Community-Level Social Determinant Associations With Acoustic Neuroma Disparities in the United States

Innovative approaches for managing patients with chronic vestibular disorders: follow-up indicators and predictive markers for studying the vestibular error signal

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