The Laryngoscope · 2025
Quality of Life Outcomes in Vestibular Schwannoma: A Prospective Analysis of Treatment Modalities.
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Hotchkies A, Heward E, Wadeson A, Heal C, Freeman S R, Rutherford S A, King A T, Pathmanaban O, Halliday J, Whitfield G, McBain C, Colaco R J, Campbell T, Goh S J, Lloyd S K W
Аннотация
OBJECTIVE: Management options for vestibular schwannoma include microsurgery (MS), stereotactic radiosurgery (SRS), and watch, wait, and rescan (WWR). This study aimed to evaluate changes in patient and disease-specific quality of life (QoL) outcomes over time, comparing each treatment modality in a matched cohort.
METHODS: A prospective cohort study recruited adult patients with sporadic vestibular schwannomas ≤ 3 cm in size undergoing treatment between January 2012 and April 2022 in a single tertiary referral center. Questionnaires were completed at diagnosis and ≥ 12 months posttreatment to assess patient-reported changes in QoL (Hearing, Dizziness, Tinnitus Handicap Inventories; Penn Acoustic Neuroma QoL questionnaire (PANQOL) and the Short Form-36 QoL questionnaire (SF-36)).
RESULTS: In total, 124 patients returned completed questionnaires (MS: 42, SRS: 42, WWR 40). The SRS group had a clinically significant deterioration in their hearing scores posttreatment (p = 0.002). Dizziness scores worsened in the MS and WWR groups posttreatment; this did not reach clinical significance. Hearing deterioration was identified in the WWR group over time using the PANQOL domain (p = 0.012). The SF-36 questionnaire showed a significant deterioration in physical functioning, role limitations, and component summary for SRS patients posttreatment (p = 0.0018, p = 0.0032, p = 0.0308). No other significant differences were seen in disease-specific or general QoL domains when comparing treatment strategies.
CONCLUSION: Outcomes in similar disease-specific domains were not consistent across questionnaires. All three treatment modalities appear to result in comparable long-term disease-specific QoL outcomes. These findings will enable evidence-based patient counseling to inform decision-making.
METHODS: A prospective cohort study recruited adult patients with sporadic vestibular schwannomas ≤ 3 cm in size undergoing treatment between January 2012 and April 2022 in a single tertiary referral center. Questionnaires were completed at diagnosis and ≥ 12 months posttreatment to assess patient-reported changes in QoL (Hearing, Dizziness, Tinnitus Handicap Inventories; Penn Acoustic Neuroma QoL questionnaire (PANQOL) and the Short Form-36 QoL questionnaire (SF-36)).
RESULTS: In total, 124 patients returned completed questionnaires (MS: 42, SRS: 42, WWR 40). The SRS group had a clinically significant deterioration in their hearing scores posttreatment (p = 0.002). Dizziness scores worsened in the MS and WWR groups posttreatment; this did not reach clinical significance. Hearing deterioration was identified in the WWR group over time using the PANQOL domain (p = 0.012). The SF-36 questionnaire showed a significant deterioration in physical functioning, role limitations, and component summary for SRS patients posttreatment (p = 0.0018, p = 0.0032, p = 0.0308). No other significant differences were seen in disease-specific or general QoL domains when comparing treatment strategies.
CONCLUSION: Outcomes in similar disease-specific domains were not consistent across questionnaires. All three treatment modalities appear to result in comparable long-term disease-specific QoL outcomes. These findings will enable evidence-based patient counseling to inform decision-making.