Quality of Life in Vestibular Schwannoma Patients: A Longitudinal Study

Objective To examine the longitudinal differences in quality of life in patients with vestibular schwannoma following a single treatment modality (observation, gamma knife radiation, or microsurgery).

Design Retrospective review.

Setting Tertiary academic medical center.

Patients Patients diagnosed with sporadic vestibular schwannoma who had completed at least two Penn Acoustic Neuroma Quality of Life (PANQOL) surveys.

Interventions Vestibular schwannoma treatment or conservative management.

Main Outcome Measures Composite PANQOL survey scores (1–100; series of 26 questions).

Results A total of 134 patients (94 observations, 24 gamma knife radiations, 16 microsurgeries) were included. The mean number of surveys completed per patient was 2.8 (±0.3), with a range of two to five surveys. The mean age of patients who had undergone microsurgery was significantly lower than either the gamma knife or observation groups (p = 0.01), and mean follow-up time was significantly higher in patients who had undergone gamma knife radiation compared with the observation or microsurgery groups (p = 0.02). Initial composite PANQOL scores were significantly worse for gamma knife (p = 0.03), but not for microsurgery (p = 0.16) as compared with observation groups. However, there was no significant difference in the rate of change of composite PANQOL scores over time across the three groups (p > 0.3).

Conclusion Although PANQOL scores initially were significantly lower for gamma knife versus observation or surgery, there was not a significant difference in the change in score over time between treatment groups. This information may be yet another valuable tool for patient counseling to determine appropriate therapy and improve outcomes.