Morbidity of Vestibular Schwannomas as Documented by Treating Providers.

OBJECTIVE

Characterize the morbidity associated with vestibular schwannoma (VS) as documented by treating providers.

STUDY

DESIGN

Retrospective analysis of the MarketScan database.

SETTING

MarketScan database.

SUBJECTS AND

METHODS

A study of morbidity in VS patients who underwent treatment between 2002 and 2012 was conducted. A detailed account of morbidity at multiple time points before and after treatment was described.

RESULTS

Of 3,355 patients treated for VS, 2,029 (60.5%) underwent surgery and 1,326 (39.5%) radiation. The average (SD) age of diagnosis was 52.5 (12.1) years. Patients were followed for a mean (SD) of 29.1 (24.2) months before and 39.2 (30.5) months after treatment. Hearing loss (65.4%), vertigo (28.0%), tinnitus (24.7%), and headache (15.2%) were the most documented symptoms at 6 months before treatment. At this juncture, higher rates of hearing loss (71.6 versus 58.6%, p < 0.0001), vertigo (32.3 versus 21.4%, p<0.0001), and tinnitus (26.9 versus 21.5%, p=0.0004) were reported for the surgery cohort. At 6 months posttreatment, surgery cohort were reported to have higher rates of hearing loss (OR 2.15, 95% CI: 1.82-2.52), vertigo (OR 1.56, 95% CI: 1.23-1.96), balance (OR 4.17, 95% CI: 3.03-5.56), facial weakness (OR 10.0, 95% CI: 6.67-14.29), headache (OR 1.56, 95% CI: 1.23-1.96), fatigue (OR 2.22, 95% CI: 1.19-4.17), and swallowing difficulties (OR 2.33, 95% CI: 1.43-3.70) compared with radiosurgery group. Surgery patients also experienced more treatment-related complications than the radiation (28.5 versus 2.6%, p<0.0001) cohort.

CONCLUSIONS

Patients who eventually underwent surgery were reported by their providers to have higher morbidity before and after treatment.