Longitudinal assessment of quality of life and audiometric test outcomes in vestibular schwannoma patients treated with gamma knife surgery

Otol Neurotol. 2011 Jun;32(4):676-9. doi: 10.1097/MAO.0b013e3182138fc5.

Abstract

Objective: To prospectively assess the quality of life (QOL) and hearing acuity in vestibular schwannoma (VS) patients after gamma knife surgery (GKS).

Patients: Fifty-nine VS patients.

Intervention: GKS.

Main outcome measures: Prospective follow-up algorithm included 36-item Short Form Health Survey (SF-36), Hearing Handicap Inventory (HHI), Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), pure-tone average, and speech discrimination hearing scores (Gardner-Robertson and American Academy of Otolaryngology), performed before and after GKS at 1-, 3-, 6-, 12-, and 18-month posttreatment intervals.

Results: From December 2006 to November 2008, 59 VS patients were treated with a median follow-up of 15 months. At baseline, mean scores for SF-36, HHI, DHI, and THI were 73, 37, 17, and 23, respectively. Median baseline Gardner-Robertson and American Academy of Otolaryngology hearing acuity scores were 2 and B, respectively. No significant decline in SF-36 health survey was noted after GKS. Mean SF-36 score at baseline was 73, compared with a range of 70 to 77 at predetermined posttreatment intervals. Similarly, no significant changes in DHI, HHI, and THI were noted. Approximately 47% of patients with baseline serviceable hearing maintained serviceable hearing at 12 months. Significant acute and chronic worsening in hearing acuity were noted at 1 and 18 months, respectively. No correlative decline in QOL was noted as assessed by SF-36 or HHI.

Conclusion: No significant decline in global QOL occurred after GKS with relatively short follow-up and approximately 50% survey completion. When discussing therapy options with VS patients, anticipated treatment-related QOL outcomes should be considered.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Audiometry
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neuroma, Acoustic / physiopathology
  • Neuroma, Acoustic / surgery*
  • Prospective Studies
  • Quality of Life*
  • Radiosurgery / instrumentation*
  • Speech Perception / physiology*
  • Treatment Outcome