Postoperative Quality of Life in Vestibular Schwannoma Patients Measured by the SF36 Health Questionnaire

Abstract

Objective: To quantify the postoperative quality of life in patients following surgical treatment for vestibular schwannoma. Study Design: Patient self. assessment using the short form 36 (SF36) multidimensional quality of life health questionnaire. Sexand age-matched normalized scores were calculated using a standardized process and accepted normative data. Setting: Tertiary referral skull base unit. Results: An 80o/ o response rate (90 patie nts) was achieved. The postoperative quality of life in vestibular schwannoma patients, as quantified by seven of the eight SF36 health scales was less than the appropriate matched healthy standard. Comparison of a variety of preoperative patients and tumor factors--different operative approaches (translabyrinthine and retrosigmoid), tumor size (group cut of points of tumor diameter 1.5 mm and 2.5 mm), patient sex, and ranking of patient age-showed no statistically significant difference in measured quality of life outcomes for each of these traditional predictors. Conclusion: Reduced quality of life in patients after surgical treatment for vestibular schwannoma, coupled with the low tumor growth rates and minimal preoperative symptoms, supports a conservative approach to patient management. The advantages and disadvantages of a variety of approaches used to measure the quality of life after surgical treatment of vestibular schwannoma and their impact on clinical decision making for patients, are discussed.

Quality of life following surgery for large and giant vestibular schwannomas: a prospective study

“…2,3,7,19,22,31 Our findings and those of Sandooram et al 26 and Di Miao et al 8 are at some variance with the findings of these studies. However, it must be pointed out that in our study we compared the QOL at follow-up with preoperative QOL, whereas in the retrospective studies, the only comparison possible was with values obtained in the general population.…”

“…1,6,13,26 Similarly, while some reports showed women to have lower scores than men, 2,14,19,20,22,31 other studies, including our own, showed no difference in SF-36 scores between male and female patients. 1,6,7 Tumor Size Several authors have reported no effect of tumor size on QOL scores. 1,6,7,23 However, others have reported a worse QOL in patients with larger tumors.…”

“…Most of the QOL studies in patients undergoing surgery for VS are retrospective and include patients with small tumors. [1][2][3][4][5][6][7]14,18,21,23,27,28,31 Few studies have reported QOL following surgery for large VS, but even those have mostly been retrospective in nature. 22,25 One of the major deficiencies in QOL studies on VS patients is the lack of a planned prospective comparison between QOL values before and after treatment in large cohorts of patients.…”

Preoperative Audiovestibular Handicap in Patients with Vestibular Schwannoma

“…This would have provided a more holistic view of each patient and taken into account other aspects of living such as pain, headache, facial symptoms, sleep, concentration, memory, activities of daily living, and work. 14,17,19 Another potential problem with the present study was the choice of questionnaires. All three questionnaires were normed using populations of symptomatic patients.…”

“…For example, in patients with conditions of varying etiology, pure tone audiometry has been shown to correlate only weakly with disability, 10,11 tinnitus intensity does not correlate with tinnitus handicap, 12 and there is no relationship between vestibular test results and dizziness handicap. 13 Although there have been several papers considering handicap, disability, and quality of life experienced by VS patients [14][15][16][17][18][19][20][21][22] these have all concentrated on the patient's condition postoperatively. The authors are unaware of any studies looking at preoperative handicap.…”