Quality of life of patients following stages III-IV vestibular schwannoma surgery using the retrosigmoid and translabyrinthine approaches.

OBJECTIVE: Surgery is an unquestionable treatment for stages III and IV vestibular schwannomas. The postoperative quality of life (QOL) remains the main issue of concern. In this study, we have evaluated the postoperative QOL of these patients operated by two surgical approaches, the retrosigmoid approach (RSA) and the translabyrinthine approach (TLA).

MATERIALS AND METHODS: This is a retrospective review of 101 stages III and IV vestibular schwannoma cases operated between 2000 and 2006 at our center by the senior author (J.M.). The Short Form SF-36 questionnaire and additional questions were sent to the patients. Comparison was made between the patient group and a control group to evaluate the postoperative QOL.

RESULTS: The response rate was 67.3%. There were 44 males and 57 females. The average follow up was 5.9 years. 59 patients were operated using the TLA and 42 using the RSA. Both patient groups had significantly lower scores on the questionnaire when compared to the normal population, and thus a less satisfactory QOL. Pain was the symptom that correlated most with poorer scores on the SF-36 questionnaire, although it was the least frequent symptom reported by the patients. Unsteadiness and facial weakness were the least bothersome complaints. Facial weakness did not correlate with a poorer QOL.

CONCLUSION: Operated stages III-IV vestibular schwannoma patients suffer from a certain degree of QOL deterioration compared to normal controls. Hearing deficit was the most prevalent symptom. Pain was the least frequent but the most bothersome and with the highest correlation with a poorer QOL. Interestingly, unsteadiness and facial weakness were the least bothersome complaints. Facial weakness did not correlate with a poorer QOL.