Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2022
Assessing Surgical Approaches for Acoustic Neuroma Resection: Do Patients Perceive a Difference in Quality-of-Life Outcomes?
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North Monique, Weishaar Jeffrey, Nuru Mohammed, Anderson Douglas, Leonetti John P
Аннотация
OBJECTIVE: The objective of this study is to further patient-physician discussion regarding postoperative quality of life expectations after surgical acoustic neuroma resection.
STUDY DESIGN: This study is retrospective prospective. Qualifying patients were identified and administered Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale.
SETTING: The setting was Loyola University Chicago Health System.
PATIENTS: Three hundred twenty-six patients at our center with surgically resected acoustic neuroma between January 1990 and July 2021 completed the PANQOL.
INTERVENTIONS: During postresection follow-up visits, patients were administered the PANQOL survey.
MAIN OUTCOME MEASURES: The total PANQOL is comprised of questions addressing quality of life in seven domains of hearing, balance, face, energy, pain, health, and anxiety. Univariate and multivariable analyses were performed to test for associations between surgical approach and/or patient characteristics.
RESULTS: Patients who were treated with retrosigmoid approach reported slightly higher PANQOL pain scores when compared with translabyrinthine approach. No association was found between responses on hearing PANQOL and surgical approach. No association was found between approach and total PANQOL score. However, on average female patients reported lower total PANQOL compared with male patients.
CONCLUSION: The lack of association between patient response on hearing PANQOL and surgical approach illustrates the impact of preoperative patient counseling in appropriately setting patient expectations. The difference in pain PANQOL response may be due to a higher rate of occipital neuralgia due to incision placement and soft tissue retraction in the retrosigmoid patient group. Surgeons may consider alternative surgical incisions and soft tissue dissection to improve patient's quality of life with respect to postoperative pain.
STUDY DESIGN: This study is retrospective prospective. Qualifying patients were identified and administered Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale.
SETTING: The setting was Loyola University Chicago Health System.
PATIENTS: Three hundred twenty-six patients at our center with surgically resected acoustic neuroma between January 1990 and July 2021 completed the PANQOL.
INTERVENTIONS: During postresection follow-up visits, patients were administered the PANQOL survey.
MAIN OUTCOME MEASURES: The total PANQOL is comprised of questions addressing quality of life in seven domains of hearing, balance, face, energy, pain, health, and anxiety. Univariate and multivariable analyses were performed to test for associations between surgical approach and/or patient characteristics.
RESULTS: Patients who were treated with retrosigmoid approach reported slightly higher PANQOL pain scores when compared with translabyrinthine approach. No association was found between responses on hearing PANQOL and surgical approach. No association was found between approach and total PANQOL score. However, on average female patients reported lower total PANQOL compared with male patients.
CONCLUSION: The lack of association between patient response on hearing PANQOL and surgical approach illustrates the impact of preoperative patient counseling in appropriately setting patient expectations. The difference in pain PANQOL response may be due to a higher rate of occipital neuralgia due to incision placement and soft tissue retraction in the retrosigmoid patient group. Surgeons may consider alternative surgical incisions and soft tissue dissection to improve patient's quality of life with respect to postoperative pain.