Impact of Facial Nerve Function on Quality of Life after Vestibular Schwannoma Surgery

Objective: In vestibular schwannoma (VS) surgery, facial nerve function is of great importance for patients' individual satisfaction and quality of life. Methods: Between 2005 and 2010, 115 patients took part in long-term evaluation. Clinical results, facial photodocumentation, SF-36 life quality questionnaires, Nottingham Health Profile, and a disease-related questionnaire were analyzed. Three subjective outcome classes (A = satisfied with procedure and outcome, B = satisfied, but mild persisting symptoms, C = not satisfied, suffering from major symptoms) were related to the primary outcome, the objective (House-Brackmann scale, HB) and the subjective facial nerve function at follow-up of 1 year. Results: At 1year, objective facial function was HB grade I in 70%, HB grade II in 16%, HB grade III in 11%. Despite normal function 12% in class A, 26% in B, and 44% in C complained of persisting subjective facial weakness. Statistical analysis showed significant reduction in energy level and well-being but normal physical activity level when compared with those patients with objective facial deficits, pointing toward a lasting depressive status and related impairment in life quality despite objective good function. Conclusion: Patients' individual constitutions play a major part in long-term subjective life quality and may be more important than objective clinical findings.