gms | German Medical Science

Objective: “Wait and see” strategy is an option in managing patients with small vestibular schwannomas (VS). Besides risk of growth and worsening of hearing quality of life may be influence patients daily life. Therefore the present study focused on quality of life parameters in patients who are on “wait and see” strategy following MRI based diagnosis of small unilateral vestibular schwannoma.

Methods: In a prospective single center study sixty-five patients (mean age 64.4 years; male-female 32:33) who suffer from a small unilateral vestibular schwannoma (9.34 mm, range 1,5-23 mm) were included from 2013 to 2016 in this series. During follow up besides clinical and neurological examination and MRI imaging all patients answered once the Short Form 36 (SF36) questionnaires to characterise Quality of Life (QOL). Additionally the severity of tinnitus was determined by the Mini-TQ-12 from Göbel and Hiller.

Results: During follow no lower QOL in patients with small vestibular schwannomas who are on “wait and see” strategy in comparison to Germany’s general population and in 53 patients (81.5 %) no tumour growth was detected. Patients with a tumour diameter larger than 10 mm do not suffer from stronger tinnitus, vertigo or unsteadiness than the group with an average tumour size which is smaller than 10 mm. 62 patients (95.4 %) showed ipsilateral hearing loss and three of them reported deafness (4.6 %). Severe vertigo or tinnitus are connected with lower levels of mental component scale (MCS) and physical component scale (PCS). This findings reduced QOL (p= 0.05).

Conclusion: In our series QOL is not influenced in patients with unilateral untreated small vestibular schwannomas in comparison to Germany`s general population. This is a helpful information in advising patients during follow up and find out optimal timing of individual treatment.