gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Preoperative audiovestibular handicap and quality of life in patients with vestibular schwannom

Das Verhältnis zwischen der präoperativen audiovestibulären Beeinträchtigung und der Lebensqualität von Patienten mit einem Vestibularisschwanomm

Meeting Abstract

  • presenting/speaker Joey Sandritter - Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Leonidas Trakolis - Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Marie Pulvermacher - Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Kathrin Machetanz - Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Florian H. Ebner - Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Marcos Tatagiba - Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Georgios Naros - Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP092

doi: 10.3205/19dgnc430, urn:nbn:de:0183-19dgnc4300

Veröffentlicht: 8. Mai 2019

© 2019 Sandritter et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Currently, there are several (partially) competing treatment strategies in patients with a unilateral sporadic vestibular schwannoma (VS), including wait-and-see, microsurgery, and radiosurgery. While tumor size and the expected hearing preservation form the primary selection criteria for the aforementioned therapeutic approaches, patients’ quality of life (QoL) is typically neglected in decision making. Nonetheless, there is strong evidence that QoL in VS is determined by other audiovestibular symptoms (i.e. dizziness and tinnitus). The aim of the present study was to evaluate the relationship between the individual audiovestibular handicap, the health-related physical and mental quality of life and tumor size.

Methods: In this prospective study, a total of 40 consecutive VS patients who were admitted for microsurgery between October 2016 and May 2017 were asked to respond to the Short Form 36 (SF-36), the Dizziness Handicap Inventory (DHI), and the Tinnitus Handicap Inventory (THI). Additionally, we determined tumor size (Hannover Grade T1-T4), hearing impairment (Gardner-Robertson scale), and facial nerve involvement (House&Brackmann scale) prior to surgical intervention.

Results: In the multivariate linear regression, DHI was the main negative predictor for physical health in this VS cohort (r2=0.332, p<0.001). In contrast, mental health was determined by the THI (r2=0.216, p=0.005). Tumor size, facial nerve and hearing impairment did not influence patients’ preoperative QoL significantly. However, there was a significant impact of tumor size on THI and DHI when comparing small/medium-sized (T1/2) to large (T3/4) VS. While THI was significant smaller in large VS, DHI tend to increase in large VS.

Conclusion: Dizziness and tinnitus determine the patients’ QoL in VS. As different therapeutic approaches (wait-and-see, microsurgery, and radiosurgery) have different effects on these audiovestibular symptoms, this could be considered in decision making. In particular, the presence of tinnitus could potentiate the case for microsurgical treatment, even in smaller VS.