Surgical Management of Endolymphatic Sac Tumor: A Systematic Review and Meta-Analysis

• Published in: Journal of International Advanced Otology Vol. 19; no. 3; pp. 248 - 254
• Main Authors: Gioacchini, Federico Maria, Chiarella, Giuseppe, Kaleci, Shaniko, Iannella, Giannicola, Viola, Pasquale, Pisani, Davide, Scarpa, Alfonso, Tulli, Michele, Re, Massimo
• Format: Journal Article
• Language: English
• Published: Turkey AVES 01.05.2023; AVES Yayincilik A.S; Mediterranean Society for Otology and Audiology; European Academy of Otology and Neurotology and the Politzer Society
• Subjects: Bone cancer; Bone Neoplasms - pathology; Ear Neoplasms - pathology; Ear Neoplasms - surgery; Endolymphatic Sac - surgery; Facial Paralysis; Humans; Literature reviews; Meta-analysis; Neoplasm Recurrence, Local - surgery; Neoplasm, Residual - pathology; Neurological disorders; Otolaryngology; Otology; Patients; Radiation therapy; Review; Software; Systematic review; Tumors; von Hippel-Lindau Disease
• ISSN: 2148-3817; 1308-7649; 2148-3817
• DOI: 10.5152/iao.2023.22957

The aim of our study was to report rates of facial nerve palsy and residual tumor following surgical intervention and subsequent tumor recurrence in patients with endolymphatic sac tumors. A systematic literature review of preoperative assessment and surgical management is also included. Studies including patient/s affected by sporadic or von Hippel-Lindau disease related endolymphatic sac tumors, reporting levels of facial nerve function, residual and recurrence pathology following a surgical procedure, were considered. Data were combined for proportional meta-analysis, and the selected studies’ methodological quality was also evaluated. Overall 34 papers, including 202 subjects (209 cases of endolymphatic sac tumors) were analyzed. Pooled proportion rate (95% CI) of overall facial nerve palsy was 39.7% (28.2-51.9) and residual tumor was 16.5% (10.3-23.7) after surgical procedure. Pooled proportion rate (95% CI) of tumor recurrence was 14.0% (9.7-19.3) during a mean follow-up period of 49.7 months (8-136). Our results showed that preoperative facial nerve function is impaired in almost 30% of patients with endolymphatic sac tumors. Surgical management of endolymphatic sac tumor may cause a worsening of facial nerve function in a low percentage of treated subjects. Residual and/or recurrence of endolymphatic sac tumors are not rare events, and follow-up strategies should be designed accordingly. Cite this article as: Maria Gioacchini F, Chiarella G, Kaleci S, et al. Surgical management of endolymphatic sac tumor: A systematic review and meta-analysis. J Int Adv Otol. 2023;19(3):248-254.