ABSTRACT
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.
KEYWORDS
Vestibular schwannoma - acoustic neuroma - quality of life - Glasgow Benefit Inventory
- SF-36
REFERENCES
- 1
Irving R M, Beynon G J, Viani L, Hardy D G, Baguley D M, Moffat D A.
The patient's perspective after vestibular schwannoma removal: quality of life and
implications for management.
Am J Otol.
1995;
16
331-337
- 2
Nikolopoulos T P, Johnson I, O'Donoghue G M.
Quality of life after acoustic neuroma surgery.
Laryngoscope.
1998;
108
1382-1385
- 3
Santarius T, D'Sousa A R, Zeitoun H M, Cruickshank G, Morgan D W.
Audit of headache following resection of acoustic neuroma using three different techniques
of suboccipital approach.
Rev Laryngol Otol Rhinol (Bord).
2000;
121
75-78
- 4
da Cruz M J, Moffat D A, Hardy D G.
Postoperative quality of life in vestibular schwannoma patients measured by the SF36
Health Questionnaire.
Laryngoscope.
2000;
110
151-155
- 5
Martin H C, Sethi J, Lang D, Neil-Dwyer G, Lutman M E, Yardley L.
Patient-assessed outcomes after excision of acoustic neuroma: postoperative symptoms
and quality of life.
J Neurosurg.
2001;
94
211-216
- 6
Betchen S A, Walsh J, Post K D.
Self-assessed quality of life after acoustic neuroma surgery.
J Neurosurg.
2003;
99
818-823
- 7
Barré P, Merle C, Conessa C, Desgeorges M, Poncet J L.
[Postoperative quality of life for patients with a vestibular schwannoma].
Ann Otolaryngol Chir Cervicofac.
2004;
121
83-94
- 8
Baumann I, Polligkeit J, Blumenstock G, Mauz P S, Zalaman I M, Maassen M M.
Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa
approach.
Acta Otolaryngol.
2005;
125
585-591
- 9
Tufarelli D, Meli A, Alesii A et al..
Quality of life after acoustic neuroma surgery.
Otol Neurotol.
2006;
27
403-409
- 10
Nicoucar K, Momjian S, Vader J P, De Tribolet N.
Surgery for large vestibular schwannomas: how patients and surgeons perceive quality
of life.
J Neurosurg.
2006;
105
205-212
- 11
Alfonso C, Lassaletta L, Sarriá J, Gavilán J.
[Quality of life following vestibular schwannoma surgery].
Acta Otorrinolaringol Esp.
2007;
58
61-65
- 12
Browne S, Distel E, Morton R P, Petrie K J.
Patients' quality of life, reported difficulties, and benefits following surgery for
acoustic neuroma.
J Otolaryngol Head Neck Surg.
2008;
37
417-422
- 13
MacAndie C, Crowther J A.
Quality of life in patients with vestibular schwannomas managed conservatively.
Clin Otolaryngol Allied Sci.
2004;
29
215-218
- 14
van Roijen L, Nijs HGT, Avezaat CJJ et al..
Costs and effects of microsurgery versus radiosurgery in treating acoustic neuroma.
Acta Neurochir (Wien).
1997;
139
942-948
- 15
Myrseth E, Møller P, Pedersen P H, Vassbotn F S, Wentzel-Larsen T, Lund-Johansen M.
Vestibular schwannomas: clinical results and quality of life after microsurgery or
gamma knife radiosurgery.
Neurosurgery.
2005;
56
927-935
discussion 927-935
- 16
Pollock B E, Driscoll CLW, Foote R L et al..
Patient outcomes after vestibular schwannoma management: a prospective comparison
of microsurgical resection and stereotactic radiosurgery.
Neurosurgery.
2006;
59
77-85
discussion 77-85
- 17
Kelleher M O, Fernandes M F, Sim D W, O'Sullivan M G.
Health-related quality of life in patients with skull base tumours.
Br J Neurosurg.
2002;
16
16-20
- 18
Sandooram D, Grunfeld E A, McKinney C, Gleeson M J.
Quality of life following microsurgery, radiosurgery and conservative management for
unilateral vestibular schwannoma.
Clin Otolaryngol Allied Sci.
2004;
29
621-627
Michael J GleesonM.D. F.R.C.S.
Department of Otolaryngology and Skull Base Surgery, Guy's Hospital
St. Thomas Street, London SE1 9RT, United Kingdom
eMail: professor.michael.gleeson@gmail.com
