The Journal of International
Advanced Otology

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


Department of Clinical and Molecular Sciences, ENT Unit, Polytechnic University of Marche, Ancona, Italy


Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy


Department of Diagnostic Medicine, Clinical and Public Health, University Hospital of Modena, Modena, Italy


Department of Sense Organs, Sapienza University Rome, Rome, Italy


Department of Medicine and Surgery, University of Salerno, Salerno, Italy

J Int Adv Otol 2023; 19: 248-254
DOI: 10.5152/iao.2023.22957
Read: 1231 Downloads: 403 Published: 01 May 2023

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.

EISSN 2148-3817