Single-fraction stereotactic radiosurgery versus microsurgical resection for the treatment of vestibular schwannoma: a systematic review and meta-analysis

Table 4 Summary of results

Outcome	Results	Grading of results
Mortality	Information on mortality was available descriptively in one study involving 91 patients. No deaths occurred during the study period of 2 years	(⇔)
Facial palsy	OR: 0.06, 95% CI: [0.02, 0.21], p < 0.001, 2 studies	⇗^a
Hearing function^b	Three studies showed statistically significant difference in favour of sfSRS compared with MR	⇗^a
Vertigo	MD: −5.97, 95% CI: [−11.98, 0.04], p = 0.052, 2 studies	⇔
Headaches^b	Two studies found no statistically significant difference between groups	⇔
Tinnitus	MD: 9.27, 95% CI: [0.84, 17.71], p = 0.031, 2 studies	⇔^c
Balance function	One study found no statistically significant difference between groups	⇔
Work disability	One study found no statistically significant difference between groups	⇔
Serious adverse events	No study reported this outcome	–
Adverse events (reinterventions)	OR: 2.62, 95% CI: [0.29, 23.57], p = 0.390, 2 studies	(⇔)
Length of hospital stay^b	Two studies showed statistically significant difference in favour of sfSRS compared with MR	⇗^a
Health-related quality of life^b	Two studies found no statistically significant difference between groups. However, one study showed a statistical significant effect in favour of sfSRS compared with MR (MD: 13.90, 95% CI: [3.02, 24.78], p = 0.013)	⇔^d

CI confidence interval, MD mean difference, MR microsurgical resection, OR odds ratio, sfSRS single-fraction stereotactic radiosurgery
^athe studies showed a very large magnitude of an effect that could not be explained by bias alone
^bit was not possible to pool the data due to the way they were reported
^ca mean difference of about 9 on a scale of 1 to 100 is not of a magnitude that cannot be explained by bias alone (no dramatic effect). There was thus no indication of greater or lesser benefit of sfSRS compared with MR for this outcome
^da mean difference of about 14 on a scale of −100 to 100 is not of a magnitude that cannot be explained by bias alone (no dramatic effect). There was thus no indication of greater or lesser benefit of sfSRS compared with MR for this outcome. ⇗, indication of greater benefit of sfSRS compared with MR.⇔, no indication of greater or lesser benefit of sfSRS compared with MR. (⇔), no indication of greater or lesser benefit of sfSRS compared with MR; the 95% CI for the relative effect is so imprecise that neither a halving nor a doubling of the effect can be excluded

ISSN: 2046-4053