Publication

Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data

van den Berge, M. J. C., van Dijk, J. M. C., Posthumus, I. A., Smidt, N., van Dijk, P. & Free, R. H., Sep-2017, In : Journal of Neurosurgery. 127, 3, p. 588-601 14 p.

Research output: Contribution to journalReview articleAcademicpeer-review

APA

van den Berge, M. J. C., van Dijk, J. M. C., Posthumus, I. A., Smidt, N., van Dijk, P., & Free, R. H. (2017). Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data. Journal of Neurosurgery, 127(3), 588-601. https://doi.org/10.3171/2016.8.JNS16992

Author

van den Berge, Minke J C ; van Dijk, J. Marc C. ; Posthumus, Iris A ; Smidt, Nynke ; van Dijk, Pim ; Free, Rolien H. / Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo : a systematic review and meta-analysis of individual patient data. In: Journal of Neurosurgery. 2017 ; Vol. 127, No. 3. pp. 588-601.

Harvard

van den Berge, MJC, van Dijk, JMC, Posthumus, IA, Smidt, N, van Dijk, P & Free, RH 2017, 'Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data', Journal of Neurosurgery, vol. 127, no. 3, pp. 588-601. https://doi.org/10.3171/2016.8.JNS16992

Standard

Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo : a systematic review and meta-analysis of individual patient data. / van den Berge, Minke J C; van Dijk, J. Marc C.; Posthumus, Iris A; Smidt, Nynke; van Dijk, Pim; Free, Rolien H.

In: Journal of Neurosurgery, Vol. 127, No. 3, 09.2017, p. 588-601.

Research output: Contribution to journalReview articleAcademicpeer-review

Vancouver

van den Berge MJC, van Dijk JMC, Posthumus IA, Smidt N, van Dijk P, Free RH. Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data. Journal of Neurosurgery. 2017 Sep;127(3):588-601. https://doi.org/10.3171/2016.8.JNS16992


BibTeX

@article{7e9b55e858be49dc8227ebaf266fe70e,
title = "Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data",
abstract = "OBJECTIVE Microvascular decompression (MVD) is regarded as a valid treatment modality in neurovascular conflicts (NVCs) causing, for example, trigeminal neuralgia and hemifacial spasms. An NVC of the cochleovestibular nerve might cause tinnitus and/or vertigo; however, general acceptance of MVD for this indication is lacking. The aim of this study was to investigate the effectiveness, safety, and prognostic factors for success of MVD of the cochleovestibular nerve.METHODS A systematic review and meta-analysis of individual patient data (IPD) were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Individual Patient Data (PRISMA-IPD) guidelines. By a comprehensive search (conducted in January 2016) in MEDLINE, EMBASE, and Google Scholar, eligible studies were identified. The collected outcome was a global measurement of improvement of 1) tinnitus, 2) vertigo, and 3) tinnitus combined with vertigo. For the meta-analysis, IPD were collected from the papers and/or from the authors. IPD were analyzed with logistic regression analysis while accounting for study clustering.RESULTS Thirty-five studies (572 patients) were included. The level of evidence provided by these studies was low. In 28{\%} of patients with tinnitus and 32{\%} of patients with vertigo, complete relief following MVD was reported. Patients with both tinnitus and vertigo had complete relief in 62{\%} of cases. In 11{\%} of patients, >= 1 complications were reported. Meta analysis of IPD (165 patients) demonstrated that patients with both tinnitus and vertigo had a higher chance of success (OR 3.8, 95{\%} CI 1.45-10.10) than patients with tinnitus alone. No other variables were significantly related to success.CONCLUSIONS Due to low success rates, MVD cannot be considered as a standard treatment method for tinnitus or vertigo. Moreover, a substantial complication rate was found. However, patients with combined symptoms had a higher chance of success. When combined symptoms occur, it is more likely that an NVC is the underlying pathology and MVD might be appropriate. Due to the low level of evidence in the included studies, this conclusion must be taken with caution. Further validation is necessary to evaluate whether patients with combined symptoms are indeed better candidates for MVD.",
keywords = "cochleovestibular nerve, microvascular decompression, neurovascular conflict, tinnitus, vertigo, functional neurosurgery, 8TH CRANIAL NERVE, DISABLING POSITIONAL VERTIGO, NEUROVASCULAR COMPRESSION SYNDROMES, VASCULAR-DECOMPRESSION, COCHLEAR NERVE, TYPEWRITER TINNITUS, SELECTION CRITERIA, PARTICIPANT DATA, SYMPTOMS, SURGERY",
author = "{van den Berge}, {Minke J C} and {van Dijk}, {J. Marc C.} and Posthumus, {Iris A} and Nynke Smidt and {van Dijk}, Pim and Free, {Rolien H}",
year = "2017",
month = "9",
doi = "10.3171/2016.8.JNS16992",
language = "English",
volume = "127",
pages = "588--601",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "AMER ASSOC NEUROLOGICAL SURGEONS",
number = "3",

}

RIS

TY - JOUR

T1 - Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo

T2 - a systematic review and meta-analysis of individual patient data

AU - van den Berge, Minke J C

AU - van Dijk, J. Marc C.

AU - Posthumus, Iris A

AU - Smidt, Nynke

AU - van Dijk, Pim

AU - Free, Rolien H

PY - 2017/9

Y1 - 2017/9

N2 - OBJECTIVE Microvascular decompression (MVD) is regarded as a valid treatment modality in neurovascular conflicts (NVCs) causing, for example, trigeminal neuralgia and hemifacial spasms. An NVC of the cochleovestibular nerve might cause tinnitus and/or vertigo; however, general acceptance of MVD for this indication is lacking. The aim of this study was to investigate the effectiveness, safety, and prognostic factors for success of MVD of the cochleovestibular nerve.METHODS A systematic review and meta-analysis of individual patient data (IPD) were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Individual Patient Data (PRISMA-IPD) guidelines. By a comprehensive search (conducted in January 2016) in MEDLINE, EMBASE, and Google Scholar, eligible studies were identified. The collected outcome was a global measurement of improvement of 1) tinnitus, 2) vertigo, and 3) tinnitus combined with vertigo. For the meta-analysis, IPD were collected from the papers and/or from the authors. IPD were analyzed with logistic regression analysis while accounting for study clustering.RESULTS Thirty-five studies (572 patients) were included. The level of evidence provided by these studies was low. In 28% of patients with tinnitus and 32% of patients with vertigo, complete relief following MVD was reported. Patients with both tinnitus and vertigo had complete relief in 62% of cases. In 11% of patients, >= 1 complications were reported. Meta analysis of IPD (165 patients) demonstrated that patients with both tinnitus and vertigo had a higher chance of success (OR 3.8, 95% CI 1.45-10.10) than patients with tinnitus alone. No other variables were significantly related to success.CONCLUSIONS Due to low success rates, MVD cannot be considered as a standard treatment method for tinnitus or vertigo. Moreover, a substantial complication rate was found. However, patients with combined symptoms had a higher chance of success. When combined symptoms occur, it is more likely that an NVC is the underlying pathology and MVD might be appropriate. Due to the low level of evidence in the included studies, this conclusion must be taken with caution. Further validation is necessary to evaluate whether patients with combined symptoms are indeed better candidates for MVD.

AB - OBJECTIVE Microvascular decompression (MVD) is regarded as a valid treatment modality in neurovascular conflicts (NVCs) causing, for example, trigeminal neuralgia and hemifacial spasms. An NVC of the cochleovestibular nerve might cause tinnitus and/or vertigo; however, general acceptance of MVD for this indication is lacking. The aim of this study was to investigate the effectiveness, safety, and prognostic factors for success of MVD of the cochleovestibular nerve.METHODS A systematic review and meta-analysis of individual patient data (IPD) were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Individual Patient Data (PRISMA-IPD) guidelines. By a comprehensive search (conducted in January 2016) in MEDLINE, EMBASE, and Google Scholar, eligible studies were identified. The collected outcome was a global measurement of improvement of 1) tinnitus, 2) vertigo, and 3) tinnitus combined with vertigo. For the meta-analysis, IPD were collected from the papers and/or from the authors. IPD were analyzed with logistic regression analysis while accounting for study clustering.RESULTS Thirty-five studies (572 patients) were included. The level of evidence provided by these studies was low. In 28% of patients with tinnitus and 32% of patients with vertigo, complete relief following MVD was reported. Patients with both tinnitus and vertigo had complete relief in 62% of cases. In 11% of patients, >= 1 complications were reported. Meta analysis of IPD (165 patients) demonstrated that patients with both tinnitus and vertigo had a higher chance of success (OR 3.8, 95% CI 1.45-10.10) than patients with tinnitus alone. No other variables were significantly related to success.CONCLUSIONS Due to low success rates, MVD cannot be considered as a standard treatment method for tinnitus or vertigo. Moreover, a substantial complication rate was found. However, patients with combined symptoms had a higher chance of success. When combined symptoms occur, it is more likely that an NVC is the underlying pathology and MVD might be appropriate. Due to the low level of evidence in the included studies, this conclusion must be taken with caution. Further validation is necessary to evaluate whether patients with combined symptoms are indeed better candidates for MVD.

KW - cochleovestibular nerve

KW - microvascular decompression

KW - neurovascular conflict

KW - tinnitus

KW - vertigo

KW - functional neurosurgery

KW - 8TH CRANIAL NERVE

KW - DISABLING POSITIONAL VERTIGO

KW - NEUROVASCULAR COMPRESSION SYNDROMES

KW - VASCULAR-DECOMPRESSION

KW - COCHLEAR NERVE

KW - TYPEWRITER TINNITUS

KW - SELECTION CRITERIA

KW - PARTICIPANT DATA

KW - SYMPTOMS

KW - SURGERY

U2 - 10.3171/2016.8.JNS16992

DO - 10.3171/2016.8.JNS16992

M3 - Review article

C2 - 27911239

VL - 127

SP - 588

EP - 601

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 3

ER -

ID: 37776992