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European Archives of Oto-Rhino-Laryngology

05-03-2024 | Vestibular Schwannoma | Review Article

Prevalence and patterns of cerebral venous sinus thrombosis following vestibular schwannoma surgery: a systematic review and meta-analysis

Authors: Arian Mirdamadi, Mona Javid, Shadman Nemati, Mohammad-Hossein Keivanlou, Mohammadreza Javid, Ehsan Amini-Salehi, Farahnaz Joukar, Soheil Hassanipour

Published in: European Archives of Oto-Rhino-Laryngology

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Abstract

Purpose

Cerebral venous sinus thrombosis (CVST) is a potentially serious complication following surgical treatment of vestibular schwannoma, a benign tumor originating from Schwann cells of the vestibulocochlear nerve. This study aimed to determine the prevalence of CVST following surgical treatment of vestibular schwannoma and the factors contributing to its occurrence.

Method

Two independent researchers searched the global databases of PubMed, Web of Science, Scopus, and the Cochrane Library up to September 01, 2023. We employed a random-effects model for data analysis. Heterogeneity was evaluated using the I2 test. To assess the quality of the studies meeting our inclusion criteria, we employed the Joanna Briggs Institute Critical Appraisal Checklist.

Results

We included 23 articles in this meta-analysis. The pooled prevalence of CVST after vestibular schwannoma surgery was 6.4% (95%CI 3.4–11.5%). The pooled prevalence of CVST following the retrosigmoid (RS), translabyrinthine (TL), and middle cranial fossa (MCF) approaches was 4.8% (95%CI 2.0–11.0%), 9.6% (95%CI 4.3–20.3%) and 9.9% (95%CI 1.6–42.2%), respectively, revealing a significant difference between the TL and the RS approaches (Odds ratio = 2.10, 95%CI 1.45–3.04, P < 0.001). The sigmoid sinus exhibited the highest post-operative thrombosis rate (7.9%), surpassing the transverse sinus (3.7%) and involvement of both sigmoid and transverse sinuses (1.6%), respectively. No significant associations were found with demographic or surgical factors.

Conclusion

In the current meta-analysis, we identified a 6.4% CVST prevalence following vestibular schwannoma surgery, with varying rates depending on the surgical approach. No significant associations with patient or surgical factors were found, emphasizing the need for heightened clinical vigilance and further research in this context.
Trail Registration: PROSPERO ID: CRD42023453513.

Graphical Abstract

Appendix
Available only for authorised users
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Metadata
Title
Prevalence and patterns of cerebral venous sinus thrombosis following vestibular schwannoma surgery: a systematic review and meta-analysis
Authors
Arian Mirdamadi
Mona Javid
Shadman Nemati
Mohammad-Hossein Keivanlou
Mohammadreza Javid
Ehsan Amini-Salehi
Farahnaz Joukar
Soheil Hassanipour
Publication date
05-03-2024
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-024-08534-y