Skull Base 2010; 20(1): 047-054
DOI: 10.1055/s-0029-1242985

© Thieme Medical Publishers

The Effect of Observation versus Microsurgical Excision on Quality of Life in Unilateral Vestibular Schwannoma: A Prospective Study

Dosh Sandooram1 , Rachael Hornigold1 , Beth Grunfeld2 , Nicholas Thomas3 , Neil D. Kitchen3 , Michael Gleeson1
  • 1Department of Otolaryngology and Skull Base Surgery, Guy's Hospital, London, United Kingdom
  • 2Department of Clinical Psychology, Guy's, King's and St. Thomas' Medical School, London, United Kingdom
  • 3Department of Neurosurgery, King's College Hospital, London, United Kingdom
Further Information

Publication History

Publication Date:
22 January 2010 (online)


With the emergence of three effective management options for vestibular schwannoma and the drastic reduction in mortality rate, the last two decades have seen increasing attention being paid to health-related quality of life. The vast majority of quality of life studies have been retrospective. We prospectively assessed quality of life of vestibular schwannoma patients before and after conservative or microsurgical management. We performed a prospective observational study conducted at a tertiary referral center between October 2001 and October 2003. Patients were divided into two groups: conservative management and microsurgery. Quality of life was assessed using the Medical Outcome Study 36-Item Short Form (SF-36) and Glasgow Benefit Inventory (GBI). The questionnaires were administered at initial assessment, 1 month, 3 months, and 6 months in both groups. Thirty-three patients completed the study, 18 in the conservative group and 15 in the microsurgical group. One month after microsurgery, SF-36 scores were significantly reduced within three of eight domains; however, 3 months after microsurgery, no significant difference existed in patients' scores on any of the SF-36 domains compared with preoperatively, and at 6 months there was a significant improvement in one domain compared with preoperatively. There was no significant difference in overall quality of life alteration (GBI total score) between microsurgery and conservative management. The improved quality of life of patients 6 months after microsurgery (relative to preoperatively, and in comparison with an age- and sex- matched population) is a new finding that has not been previously documented in the literature.


Michael J Gleeson, M.D. , F.R.C.S. 

Department of Otolaryngology and Skull Base Surgery, Guy's Hospital

St. Thomas Street, London SE1 9RT, United Kingdom