Evidence map›Paper›PMID 39969785›Full record

SynthesisJournal of neuro-oncology2025

Tinnitus after treatment of vestibular schwannoma: a systematic review and comparative analysis of microsurgery and stereotactic radiosurgery.

Ramkumar Govindaraj, Courtney Chambers, Marcus Kha, Thomas Sullivan, Sharad Chawla, Andrew Zacest, Peter Gorayski, Daniel Roos

Abstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ramkumar GovindarajDepartment of Radiation Oncology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia. Ramkumar.Govindaraj@sa.gov.au.ORCID http://orcid.org/0000-0002-7229-7179
Courtney ChambersDepartment of Radiation Oncology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Marcus KhaDepartment of Radiation Oncology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Thomas SullivanWomen and Kids Theme, South Australian Health & Medical Research Institute, Adelaide, South Australia, Australia.
Sharad ChawlaDepartment of Otolaryngology, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia.
Andrew ZacestFaculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Peter GorayskiDepartment of Radiation Oncology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Daniel RoosDepartment of Radiation Oncology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this systematic review and meta-analysis was to compare tinnitus outcomes following microsurgery and stereotactic radiosurgery for vestibular schwannoma.

methodsThe databases MEDLINE (via Ovid), EMBASE (via Ovid), Cochrane Central Register of Controlled Trials (via Ovid), SCOPUS, CINAHL (EBSCO), and Web of Science were searched for studies comparing microsurgery and radiosurgery treatment, and reporting tinnitus outcomes. Longitudinal tinnitus assessment with pre-treatment evaluation was required for inclusion. Fractionated radiotherapy treatment was excluded. Newcastle-Ottawa scale was used to assess the quality of the included studies. A separate random-effects meta-analysis was performed for the continuous, binary and ordinal tinnitus outcomes, with pooled effects described as a standardised mean difference or a log odds ratio as appropriate.

resultsThirteen studies involving 5814 patients were included in the review; 4 were prospective studies, and the rest were retrospective cohort studies. The median follow-up duration in the microsurgery and radiosurgery groups was 39.5 months and 41.1 months, respectively. Studies were diverse with respect to inclusion criteria and method of tinnitus outcome assessment. Only 4 studies reported tinnitus scores using tinnitus questionnaires, while others used Likert scale, visual analogue scale, binary (present or absent) scale or ordinal (improved, same or worse) scale. Four studies reported better tinnitus outcomes after microsurgery than radiosurgery. However, the overall quality of the studies was low, and most did not control for important confounders, such as age, tumour characteristics, and hearing impairment. Meta-analysis of continuous and binary tinnitus outcomes showed no difference between the interventions (standardised mean difference = -0.04, 95% CI -0.37 to 0.28, p = 0.80; log odds ratio = 0.32, 95% CI -1.11 to 1.74, p = 0.66). Meta-analysis of tinnitus outcomes on an ordinal scale showed microsurgery increased the odds of reporting improved tinnitus compared to radiosurgery (log odds ratio = 0.83, 95% CI 0.01 to 1.64, p = 0.045). Heterogeneity between the studies was high for all outcome measures (I

conclusionMeta-analyses of tinnitus outcomes were largely inconclusive, except when tinnitus was reported as an ordinal outcome, which favoured microsurgery. However, due to the low quality of studies and high heterogeneity, no definitive conclusions could be drawn favouring either treatment.

Indexed as

MicrosurgeryNeuroma, AcousticRadiosurgeryTinnitusHumansMicrosurgeryStereotactic radiosurgerySystematic reviewTinnitusVestibular schwannoma

Identifiers

PMID39969785
PMCPMC11937193

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.