What determines quality of life in patients with vestibular schwannoma?

Abstract

Objectives Patients with a vestibular schwannoma (VS) experience a reduced quality of life (QoL). The main objective of this study was to determine the strongest predictors reducing physical and mental QoL from the disease‐specific Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire in patients with VS. Design Observational study. Setting Radboudumc Skull Base Centre, Nijmegen. Participants Patients newly diagnosed with VS between 2014 and 2017 managed with either observation, stereotactic radiosurgery or microsurgery. Main outcome measures Quality of life was assessed using the disease‐specific PANQOL and general Short‐Form (36) Health Survey (SF‐36). Multiple linear regression models with PANQOL domains as predictors were used to determine the strongest predictors for SF‐36 QoL physical and mental health scores. Standardised beta coefficients (β) were used for ranking. Results A total of 174 patients (50% females, mean age 58.9 years) returned the questionnaires, providing a 69% response rate. Fifteen patients (9%) were treated with microsurgery, 29 (17%) with stereotactic radiosurgery and 130 patients (75%) were observed in a wait and scan strategy. A lack of energy (β = .28; P ≤ .001), lower general health (β = .22; P ≤ .001), headache (β = .16; P ≤ .001), anxiety (β = .15; P ≤ .001) and balance problems (β = .10; P ≤ .001) are the strongest predictors affecting physical health, while mental health is most affected by anxiety (β = .37; P ≤ .001), a lack of energy (β = .34; P ≤ .001), facial nerve dysfunction (β = .07; P ≤ .001), balance problems (β = .04; P ≤ .001) and headaches (β = .04; P ≤ .001). Conclusion A lack of energy, anxiety, headache and balance problems are the strongest predictors of both SF‐36 physical and mental QoL in patients with VS. More awareness and supportive care regarding energy, anxiety, headache and balance in informing, evaluating and treating patients with VS could improve QoL.

Dizziness After Traumatic Brain Injury: A Prospective TRACK-TBI Analysis of Risk Factors, Quality of Life, and Neurocognitive Effects

“…In other disease states, dizziness is associated with quality of life and neurocognitive effects. For patients with acoustic neuroma, dizziness was the strongest predictor of quality of life and physical and mental health (12)(13)(14). For bilateral vestibulopathy, dizziness had a significant impact on physical and social functioning and overall quality of life (15).…”

Factors Influencing Personalized Management of Vestibular Schwannoma: A Systematic Review

“…Current goals of modern treatment include both maintaining long-term tumor control and maximizing FN function and QoL. FN dysfunction after surgery, in fact, has a significant impact on patients’ QoL and more emphasis is now being placed on preserving FN function at the cost of leaving residual tumors behind [ 8 , 43 , 44 , 45 , 46 ].…”

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

“…In comparison with a “normal population,” as well as with VS patients that are conservatively managed, the QoL of surgically treated patients has been reported to be poorer [ 1 , 2 , 16 , 17 ]. Selection bias has been reported since patients that undergo a watch-and-wait protocol usually present with smaller tumors and better hearing compared to those undergoing surgery.…”

“…While hearing and balance also represent the most affected domains in other series of surgically treated patients [ 12 , 13 , 16 ], general health was reported to be significantly impaired only by Pruijn et al [ 16 ]. Such non-homogeneous results have been attributed to the fact that only two questions explore the general health domain in the PANQOL questionnaire and lead to a poor internal consistency of this scale [ 12 ].…”