title: Risk Factors of Acoustic Neuroma: Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  Many epidemiological studies have investigated environmental risk factors for the development of acoustic neuroma. However, these results are controversial. We conducted a meta-analysis of case-control studies to identify any potential relationship between history of noise exposure, smoking, allergic diseases, and risk of acoustic neuroma.
  
  
  METHODS
  We searched PubMed to identify relevant articles. Two researchers evaluated the eligibility and extracted the data independently.
  
  
  RESULTS
  Eleven case-control studies were included in our meta-analysis. Acoustic neuroma was found to be associated with leisure noise exposure [odds ratio (OR)=1.33, 95% confidence interval (CI): 1.05-1.68], but not with occupational noise exposure and ever noise exposure (OR=1.20, 95% CI: 0.84-1.72 and OR=1.15, 95% CI: 0.80-1.65). The OR of acoustic neuroma for ever (versus never) smoking was 0.53 (95% CI: 0.30-0.94), while the subgroup analysis indicated ORs of 0.95 (95% CI: 0.81-1.10) and 0.49 (95% CI: 0.41-0.59) for ex-smoker and current smoker respectively. The ORs for asthma, eczema, and seasonal rhinitis were 0.98 (95% CI: 0.80-1.18), 0.91 (95% CI: 0.76-1.09), and 1.52 (95% CI: 0.90-2.54), respectively.
  
  
  CONCLUSIONS
  Our meta-analysis is suggestive of an elevated risk of acoustic neuroma among individuals who were ever exposed to leisure noise, but not to occupational noise. Our study also indicated a lower acoustic neuroma risk among ever and current cigarette smokers than never smokers, while there was no significant relationship for ex-smokers. No significant associations were found between acoustic neuroma and history of any allergic diseases, such as asthma, eczema, and seasonal rhinitis.
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Mantao
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Zuoxu
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. zd05lcyxcmt@sina.com.
authors.forename: Xiujue
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Cao
authors.affiliation: Department of Infant Health Care, Xiacheng Traditional Chinese Medical Hospital, Hangzhou, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006967:Hypersensitivity; D007899:Leisure Activities; D009464:Neuroma, Acoustic / Q000453:epidemiology / Q000209:etiology*; D009622:Noise / Q000009:adverse effects*; D016273:Occupational Exposure / Q000009:adverse effects; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
keywords: Noise; acoustic neuroma; allergy; meta-analysis; smoking