{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T21:21:18Z","timestamp":1785532878660,"version":"3.56.0"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T00:00:00Z","timestamp":1548633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We sought to compare balance outcomes according to treatment modality of vestibular schwannoma (VS) via a meta\u2010analysis that divided measuring tools of balance outcomes into three categories based on type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive review of the literature from January 1966 to September 2017 was performed, looking for studies about long\u2010term balance outcomes after microsurgery (MS), radiotherapy (RT), or observation for VS. A comprehensive meta\u2010analysis was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and Egger's regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 633 references, 34 were included in the meta\u2010analysis. Perceived dizziness improvement rate was significantly higher in the MS group than in the RT group (odds ratio [OR]: 1.61; 95% confidence interval [CI]: 1.08 to 2.40; <jats:italic>P<\/jats:italic> &lt;\u2009.05, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> =\u20094.18], but no significant difference was observed between the two groups with regard to validated dizziness questionnaire score (standardized mean difference: 0.04; 95% CI: \u22120.36 to 0.44; <jats:italic>P<\/jats:italic> =\u2009.84, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> =\u200969.61) or dizziness or disequilibrium\u2010related symptom incidence rate (OR: 0.91; 95% CI: 0.50 to 1.68; <jats:italic>P<\/jats:italic> =\u2009.77, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> =\u20090). In a subanalysis conducted within the groups after intervention, the MS group demonstrated a lower vertigo incidence rate (<jats:italic>P<\/jats:italic> &lt;\u2009.001), and the RT group experienced a significant reduction in validated dizziness questionnaire score (<jats:italic>P<\/jats:italic> &lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results indicate that MS should be considered at least equal to RT in regard to resolving long\u2010term dizziness and improving balance outcomes. Furthermore, well\u2010designed studies are necessary to predict balance outcomes after VS treatment and to choose from among possible treatment options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2a <jats:italic>Laryngoscope<\/jats:italic>, 130:178\u2013189, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27830","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T08:04:59Z","timestamp":1548749099000},"page":"178-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of balance outcomes according to treatment modality of vestibular schwannoma"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1914-8331","authenticated-orcid":false,"given":"Gaeun","family":"Kim","sequence":"first","affiliation":[{"name":"Research Institute for Nursing Science Keimyung University, College of Nursing  Daegu South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4880-7033","authenticated-orcid":false,"given":"Timothy E.","family":"Hullar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health and Science University  Portland Oregon U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-8581","authenticated-orcid":false,"given":"Jae\u2010Hyun","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery College of Medicine, The Catholic University of Korea  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.1.JNS121370"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200604000-00018"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25110"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000219838.80931.6B"},{"key":"e_1_2_7_6_1","unstructured":"HigginsJP GreenS.Cochrane Handbook for Systematic Reviews of Interventions. 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