Long-Term Prospective Quality-of-Life Outcomes in 445 Patients with Sporadic Vestibular Schwannoma.

Abstract

To evaluate the long-term changes in sporadic vestibular schwannoma (VS) disease-specific quality-of-life (QOL) outcomes. Prospective longitudinal study using the Penn Acoustic Neuroma Quality of Life (PANQOL) Scale. National survey. Patients with sporadic VS who completed a baseline survey before treatment and at least one follow-up survey recruited through the authors' center and through the Acoustic Neuroma Association. Observation, microsurgery, radiosurgery. Changes in PANQOL scores from baseline to most recent survey. Among 445 eligible patients the mean duration of follow-up was 4.4 (SD, 2.3) years, including 122, 218, and 105 in the observation, microsurgery, and radiosurgery groups, respectively. Patients managed with observation (p = 0.03) or microsurgery (p < 0.001) demonstrated improvement in anxiety scores. Changes in facial function scores differed significantly by management group (p = 0.01), with patients undergoing microsurgery demonstrating a mean decline of 10 points in facial function scores compared with mean declines of 3 for those managed with observation or radiosurgery. Hearing loss scores decreased similarly over time for all three groups (p = 0.3). There were minimal changes in total PANQOL scores over time across all management groups (p = 0.5). Long-term changes in total QOL among VS management groups are not significantly different. Microsurgery may continue to confer an advantage regarding improvement in anxiety postoperatively, but with a greater decline in facial function when compared to observation or radiosurgery. Long-term declines in hearing loss scores were not statistically significantly different among groups.