gms | German Medical Science

Objective: Long term data about patient health-related quality of life (HRQoOL) following surgery of vestibular schwannomas (VS) is rare. Patients have a favourable prognosis, it is important to evaluate how they fair in the long-term. The aim of our project is to evaluate QOL of patients who underwent surgery in long-term follow up (FU).

Methods: A total of 304 patients who underwent surgery for first diagnosis in 2004-2009 were approached by mail to complete the Dizziness Handycap Scale (DHS), Penn Acoustic Neuroma Quality of Life (PANQOL, disease specific for VS with 8 domains, a score reaching from 0 (worst) to 100 (best), higher scores indicating better function resp. lower symptom load) and Short Form Health Survey-36 (SF-36). We present data descriptively and compared patient groups by treatment or disease related deficits with Mann-Whitney-U-Test.

Results: Responses of n=67 patients were analyzed (22.0%). Mean age at surgery was 50y, n= 39 (58%) are female. Mean FU was 12 years (range: 10-16). Mean domain PANQOL scores were: Anxiety (ANX) 79 (±19), Facial Dysfunction (FAC), 82 (±21), Balance (BAL) 65 (±23), Hearing Loss (HEA) 57 (±25), Energy (ENE) 67 (±21), Pain (PAI) 75 (±28), General Health (GEN) 65 (±19), Total Score (TOT) 70 (±17). An age-adapted comparison of the SF-36 data to the German general population via z-test showed no significant differences (Physical Functioning (PHY) 84 (±19), Role Limitation Physical (RLP) 77 (±38), Bodily Pain (BOP) 83 (±24), General Health (GEN) 69 (±18), Vitality (VIT) 57 (±19), Social Functioning (SOF) 79 (±23), Role Limitation Emotional (RLE) 76 (±39), Mental Health (MH) 68 (±19)). Problems in balance assessed by the DHS were significantly associated with lower HRQoL regarding all subscales of the SF-36, and also for BAL, PAI, ANX, HEA, ENE and TOT on the PANQOL. Facial nerve paresis (House & Brackman °I-II vs. °III-V) was significantly associated with worse disease specific QoL according to PANQOL (FAC p<0.001, ANX p=0.002 and TOT p=0.007).

Conclusion: Although a certain selection bias has to be taken into account, we assume that long-term HRQoL in patients who underwent surgery for VS is not significantly different to the general populations’ HRQoL. However, as measured by the disease specific questionnaire PANQOL, neurological deficits (balance and facial nerve paresis) were associated with reduced HRQoL more than 10 years after surgery.