Tufarelli Davide, Meli Annalisa, Alesii Annalisa, De Angelis Ezio, Badaracco Carlo, Falcioni Maurizio, Sanna Mario
Department of Othorinolaryngological Rehabilitation San Raffaele Pisana, Rome,
Otol Neurotol. 2006 Apr;27(3):403-9. doi: 10.1097/00129492-200604000-00018.
The aim of this study is to assess patients' quality of life after acoustic neuroma surgery, and if some patients' characteristics, parameters of tumor and surgical parameters affect patients' quality of life.
Retrospective study.
Tertiary care center.
A group of 386 patients who underwent acoustic neuroma surgery.
Patients included were derived from a population of 459 subjects operated for acoustic neuroma by the Otologic Group of Piacenza.
The outcome of the questionnaires on quality of life (SF 36), the Dizziness Handicap Inventory (DHI) and a questionnaire of patients' histories were analyzed.
In our sample a group of 231 patients were asymptomatic after surgery, while 155 patients reported very really disabling symptoms. Hearing loss was perceived as the most disabling symptom. The scores of questionnaire on quality of life were lower than scores for the normal population. The indices of disablement influenced the perception of quality of life.
Our study has shown that patients perceived a worsening of their quality of life, in particular women and patients over 45. Surgery caused a higher percentage of disability. Patients' quality of life can be used as a parameter for the timing of surgery. Our data indicate that an early surgical approach for intrameatal tumor is better than waiting for an increase in the tumor size. A "wait-and-scan" strategy for extrameatal neuromas which do not affect the brainstem is preferable, since these patients have a worsening of their quality of life after surgery independently of the tumor size.
本研究旨在评估听神经瘤手术后患者的生活质量,以及某些患者特征、肿瘤参数和手术参数是否会影响患者的生活质量。
回顾性研究。
三级医疗中心。
一组386例行听神经瘤手术的患者。
纳入的患者来自皮亚琴察耳科组为459例听神经瘤患者实施手术的人群。
分析生活质量问卷(SF 36)、头晕残障量表(DHI)及患者病史问卷的结果。
在我们的样本中,一组231例患者术后无症状,而155例患者报告有非常严重的致残症状。听力损失被认为是最致残的症状。生活质量问卷得分低于正常人群得分。致残指数影响生活质量感知。
我们的研究表明,患者感觉其生活质量下降,尤其是女性和45岁以上患者。手术导致更高比例的残疾。患者的生活质量可作为手术时机的一个参数。我们的数据表明,对于内耳道肿瘤,早期手术方法优于等待肿瘤增大。对于不影响脑干的外耳道神经瘤,采用“观察并扫描”策略更为可取,因为这些患者术后生活质量下降与肿瘤大小无关。