Postoperative Impact of Pontocerebellar Angle Surgery on the Quality of Life in Patients with Vestibular Schwannoma

Abstract

Background: Vestibular Schwannomas are benign tumors arising from the VIII CN. Surgical treatment is indicated in case of tumors larger than 2.5 cm in the cerebellopontine angle or in the case of cranial nerve dysfunction. The aim of the present study was to evaluate the QoL by means of the PANQOL questionnaire in a group of surgically treated patients mainly affected by large and giant VS Methods: All patients underwent preoperative and postoperative otoneurological evaluation and gadolinium enhanced MRI and they completed, independently, the PANQOL questionnaire at last follow up. Results: 70% of patients presented with large Koos III or IV VS Each domain of PANQOL showed a strong correlation with the total PANQOL score. In relation to the postoperative facial nerve function, patients with poorer function showed significantly lower score in the facial dysfunction and pain, patients with postoperative balance problems showed a significantly lower PANQOL score for domains of balance and pain. Conclusions: This study showed that postoperative QoL of patients was acceptable even if there were some domains that were more affected, such as hearing and balance domains; therefore, the lowest scores suggest the need for vestibular rehabilitation programs and strategies that improve postoperative hearing.

Outcome measures in neurosurgery: Is a unified approach better? A literature review

“…examined the quality of life in patients after vestibular schwannoma surgery. [ 7 ] They reached the conclusion that the quality of life of the selected patients after the surgery was acceptable in most of the domains, with other ones being more affected, such as hearing and balance. Vestibular rehabilitation programs and effective strategies to tackle hearing problems are recommended for postoperative cases with low scores.…”

“…Vestibular rehabilitation programs and effective strategies to tackle hearing problems are recommended for postoperative cases with low scores. [ 7 ] The generated discussion in the literature is may pinpoint the need for disease-specific outcome measures to gain a more reliable measure of the intervention and future steps in patients’ management.…”

“…Moreover, the future direction of measuring the quality of life in neurosurgery is getting more specialized and focused, and there is a need for diseasespecific outcome measures to ensure an accurate assessment of the patients. [7] e topic of this paper and its related discussion can be highlighted in the future in a comprehensive systematic review utilizing PRISMA guidelines. [30] Quality of life as end-point…”

Hearing preservation surgery for vestibular schwannoma: a systematic review and meta-analysis

“…The trans-labyrinthine (TL) approach allows a large exposure of the IAC and CPA with minimal cerebellar retraction and complete control of the facial nerve. However, it does not preserve residual hearing 5 and will not be discussed further in the present review. The retro-sigmoid (RS) approach is a potentially hearing preserving technique that offers a large view of the CPA.…”

“…At present, treatment options include a conservative approach (wait and scan [W&S] policy), stereotactic radiosurgery (SRS), and microsurgery with or without hearing preservation 5-11 . The choice depends on different factors, such as patient’s age and comorbidities, size and location of the tumour, and hearing status.…”