Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T18:12:03.552Z Has data issue: false hasContentIssue false

Quality of life after vestibular schwannoma surgery: does hearing preservation make a difference?

Published online by Cambridge University Press:  27 November 2009

A P Iyer*
Affiliation:
Department of Otolaryngology, Auckland City Hospital, Auckland, New Zealand
R Gunn
Affiliation:
Department of Otolaryngology, Auckland City Hospital, Auckland, New Zealand
H Sillars
Affiliation:
Department of Otolaryngology, Auckland City Hospital, Auckland, New Zealand
*
Address for correspondence: Mr Arunachalam P Iyer, Consultant ENT Surgeon, NHS Lanarkshire, Wishaw General Hospital, Wishaw ML2 0DP, UK. Fax: 01698 366010 E-mail: [email protected]

Abstract

Objective:

Surgery for vestibular schwannoma may reduce patients' quality of life, but the effect of hearing preservation on this process is not fully understood. Our aim was to determine whether hearing preservation makes a difference to patients' quality of life in this clinical setting.

Study design:

Retrospective questionnaire and cross-sectional survey.

Methods:

The study included 104 consecutive patients who had undergone surgery for vestibular schwannoma between 1998 and 2004. Surgery was via a middle cranial fossa route in 24 patients and a translabyrinthine route in 79. Quality of life was assessed using the SF-36 questionnaire and the Glasgow Benefit Inventory.

Results:

Quality of life was reduced in both patient groups, with a mean Glasgow Benefit Inventory score of −7.5 (confidence interval (CI) −13 to −2.5) in the translabyrinthine patients and −4 (confidence interval −13.5 to 5.5) in the middle fossa patients. The SF-36 scores did not show any statistically significant difference between the two groups, except for social function (p = 0.01).

Conclusions:

Surgery for vestibular schwannoma reduces patients' quality of life, and the preservation of hearing, achieved by using a middle fossa surgical approach, does not significantly alter this result.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Otolaryngological Research Society Meeting, 30th September 2005, London, and Section of Otology of RSM at the Royal Society of Medicine, 3rd March 2006, London, UK.

References

1 Valvassori, GE, Guzman, M. Growth rate of acoustic neuromas. Am J Otol 1989;10:174–6Google ScholarPubMed
2 Strasnick, B, Glasscock, ME 3rd, Haynes, D, McMenomey, SO, Minor, LB. The natural history of untreated acoustic neuromas. Laryngoscope 1994;104:1115–19CrossRefGoogle ScholarPubMed
3 Andersson, G, Ekvall, L, Kinnefors, A, Nyberg, G, Rask-Andersen, H. Evaluation of quality of life and symptoms after translabyrinthine acoustic neuroma surgery. Am J Otol 1997;18:421–6Google ScholarPubMed
4 Nikolopoulos, TP, Johnson, I, O'Donoghue, GM. Quality of life after acoustic neuroma surgery. Laryngoscope 1998;108:1382–5CrossRefGoogle ScholarPubMed
5 Da Cruz, MJ, Moffat, DA, Hardy, DG. Postoperative quality of life in vestibular schwannoma patients measured by the SF36 Health Questionnaire. Laryngoscope 2000;110:151–5CrossRefGoogle ScholarPubMed
6 Inoue, Y, Ogawa, K, Kanzaki, J. Quality of life of vestibular schwannoma patients after surgery. Acta Otolaryngol 2001;121:5961Google ScholarPubMed
7 Martin, HC, Sethi, J, Lang, D, Neil-Dwyer, G, Lutman, ME, Yardley, L. Patient-assessed outcomes after excision of acoustic neuroma: postoperative symptoms and quality of life. J Neurosurg 2001;94:211–16CrossRefGoogle ScholarPubMed
8 Betchen, SA, Walsh, J, Post, KD. Self-assessed quality of life after acoustic neuroma surgery. J Neurosurg 2003;99:818–23CrossRefGoogle ScholarPubMed
9 Tos, T, Caye-Thomasen, P, Stangerup, SE, Tos, M, Thomsen, J. Long-term socio-economic impact of vestibular schwannoma for patients under observation and after surgery. J Laryngol Otol 2003;117:955–64CrossRefGoogle ScholarPubMed
10 Tos, T, Caye-Thomasen, P, Stangerup, SE, Tos, M, Thomsen, J. Patients' fears, expectations and satisfaction in relation to management of vestibular schwannoma: a comparison of surgery and observation. Acta Otolaryngol 2003;123:600–5CrossRefGoogle ScholarPubMed
11 Sandooram, D, Grunfeld, EA, McKinney, C, Gleeson, MJ. Quality of life following microsurgery, radiosurgery and conservative management for unilateral vestibular schwannoma. Clin Otolaryngol 2004;29:621–7CrossRefGoogle ScholarPubMed
12 MacAndie, C, Crowther, JA. Quality of life in patients with vestibular schwannomas managed conservatively. Clin Otolaryngol 2004;29:215–18CrossRefGoogle ScholarPubMed
13 Myrseth, E, Moller, P, Pedersen, PH, Vassbotn, FS, Wentzel-Larsen, T, Lund-Johansen, M. Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery 2005;56:927–35Google ScholarPubMed
14 Baumann, I, Polligkeit, J, Blumenstock, G, Mauz, PS, Zalaman, IM, Maassen, MM. Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa approach. Acta Otolaryngol 2005;125:585–91CrossRefGoogle ScholarPubMed
15 Lin, VY, Stewart, C, Grebenyuk, J, Tsao, M, Rowed, D, Chen, J et al. Unilateral acoustic neuromas: long-term hearing results in patients managed with fractionated stereotactic radiotherapy, hearing preservation surgery, and expectantly. Laryngoscope 2005;115:292–6CrossRefGoogle ScholarPubMed
16 Ryzenman, JM, Pensak, ML, Tew, JM Jr. Facial paralysis and surgical rehabilitation: a quality of life analysis in a cohort of 1,595 patients after acoustic neuroma surgery. Otol Neurotol 2005;26:516–21CrossRefGoogle Scholar
17 Ryzenman, JM, Pensak, ML, Tew, JM Jr. Headache: a quality of life analysis in a cohort of 1,657 patients undergoing acoustic neuroma surgery, results from the acoustic neuroma association. Laryngoscope 2005;115:703–11CrossRefGoogle Scholar
18 Myrseth, E, Moller, P, Wentzel-Larsen, T, Goplen, F, Lund-Johansen, M. Untreated vestibular schwannomas: vertigo is a powerful predictor for health-related quality of life. Neurosurgery 2006;59:6776Google ScholarPubMed
19 Lassaletta, L, Alfonso, C, Del Rio, L, Roda, JM, Gavilan, J. Impact of facial dysfunction on quality of life after vestibular schwannoma surgery. Ann Otol Rhinol Laryngol 2006;115:694–8CrossRefGoogle ScholarPubMed
20 Gardner, G, Robertson, JH. Hearing preservation in unilateral acoustic neuroma surgery. Ann Otol Rhinol Laryngol 1988;97:5566CrossRefGoogle ScholarPubMed
21 Taking the Pulse – the 1996/97 New Zealand Health Survey. Wellington, New Zealand: Ministry of Health, 1999Google Scholar