Long-term Quality of Life Following Vestibular Schwannoma Excision Via the Translabyrinthine Approach

Stephen J. Broomfield*, Ashish K. Mandavia, Jack S. Nicholson, Osama Mahmoud, Andrew T. King, Scott A. Rutherford, Richard T. Ramsden

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)
276 Downloads (Pure)

Abstract

Objective: To assess post-operative quality of life (QOL) and other patient-reported outcomes following surgery for vestibular schwannoma.

Study Design: Cross-sectional retrospective case review using postal questionnaires.

Setting: Tertiary referral centre.

Patients: Five hundred consecutive patients undergoing surgery for vestibular
schwannoma.

Intervention(s): Patients undergoing surgery via the translabyrinthine approach
(excluding neurofibromatosis type 2) under the senior author, with a minimum of five years follow-up, were included.

Main Outcome Measure(s): QOL was assessed using the Short Form 36 (SF-36)
questionnaire and a disease-specific survey to assess patients' subjective outcomes.

Results: The SF-36 scores in this group were significantly lower than the general UK population, though 24% of respondents reported a subjective improvement in overall QOL. Tumours larger than 4cm were related to a reduced SF-36 total mental component score (P = 0.037). Increased age at time of surgery correlated with a reduced physical component of QOL (correlation coefficient = -0.26) and an improved mental component (correlation coefficient = 0.26). Subjective reports of post-operative symptoms and return to work, driving and social activities were similar to other published studies. 35% of patients reported vivid dreams or nightmares following surgery; the first reported incidence of this phenomenon in a large group of vestibular schwannoma patients.

Conclusions: Generic measures of QOL in patients following translabyrinthine surgery for vestibular schwannoma do not always match subjective reports, reflecting the complexity of QOL assessment and the range of outcomes in this group. Increased time since surgery appears to be associated with an improvement in mental health.
Original languageEnglish
Pages (from-to)1165-1173
Number of pages9
JournalOtology and Neurotology
Volume38
Issue number8
Early online date1 Sep 2017
DOIs
Publication statusPublished - 1 Sep 2017

Keywords

  • Acoustic neuroma (vestibular schwannoma)
  • Quality of life
  • Surgery

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