| Autor: |
Gheorghe L; Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania.; Emergency Clinical Hospital 'Sfântul Spiridon' Iasi, 700111 Iasi, Romania., Negru D; Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania.; Emergency Clinical Hospital 'Sfântul Spiridon' Iasi, 700111 Iasi, Romania., Cobzeanu MD; Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania.; Emergency Clinical Hospital 'Sfântul Spiridon' Iasi, 700111 Iasi, Romania., Palade OD; Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania.; Emergency Clinical Hospital 'Sfântul Spiridon' Iasi, 700111 Iasi, Romania., Botnariu EG; Emergency Clinical Hospital 'Sfântul Spiridon' Iasi, 700111 Iasi, Romania.; Internal Medicine Department, Faculty of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania., Cobzeanu BM; Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania.; Clinical Rehabilitation Hospital, 700661 Iasi, Romania., Cobzeanu ML; Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania.; Emergency Clinical Hospital 'Sfântul Spiridon' Iasi, 700111 Iasi, Romania. |
| Abstrakt: |
(1) Background: Magnetic resonance imaging (MRI) is the gold standard investigation for all patients who present with asymmetrical hearing loss (AHL) and a high index of suspicion for vestibular schwannoma (VS). However, pure-tone audiometry (PTA) is an investigation that can be used for the screening of these patients in order to reduce the costs. The aim of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of different PTA protocols for VS in patients with ASHL, when compared with MRI; (2) Methods: Medline, Embase, and Cochrane databases were used to find relevant studies. All prospective and retrospective observational studies that evaluated the accuracy of PTA protocols for the screening of VS were assessed, according to the international guidelines; (3) Results: We analyzed seven studies (4369 patients) of poor-to-moderate quality. Their pooled sensitivity was good (0.73-0.93), but their specificity was low (0.31-0.60). All protocols were located in the right lower quadrant on the likelihood scattergram, and the post-test probabilities for positive and negative diagnosis of these protocols were extremely low; (4) Conclusions: PTA protocols cannot be used for a proper screening or diagnosis of vestibular schwannoma despite their good sensibility, and MRI remains the gold standard for this purpose. |
