Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, USA.
Division of Otolaryngology-Head and Neck Surgery, University of Montreal, Montreal, Canada.
Otol Neurotol. 2021 Aug 1;42(7):1074-1080. doi: 10.1097/MAO.0000000000003137.
To examine the relationship between the Functional Gait Assessment (FGA) and quality of life (QOL) measurements relating to balance before and after vestibular schwannoma (VS) resection and to assess the role of preoperative FGA in predicting postoperative QOL.
A prospective clinical study of adult patients undergoing VS resection between September 2018 and December 2019. FGA was administered 1 week before and after surgery. Dizziness Handicap Inventory (DHI) and Penn Acoustic Neuroma Quality of Life (PANQOL) were administered preoperatively and at 3 months postoperatively.
Single tertiary center.
Patients (age ≥ 18 years old) with VS undergoing microsurgical resection. Excluded were patient with previous surgery or radiation.
VS resection.
Primary outcome: correlation between FGA and QOL surveys. Secondary outcome: correlation between preoperative measurements of balance and postoperative PANQOL.
One hundred thirty-eight patients were analyzed (mean age: 48 years old, 65.9% female). The translabyrinthine approach was most commonly performed. Under multivariate analysis, preoperative FGA significantly correlated with preoperative PANQOL balance score (p < 0.0001), preoperative PANQOL total score (p = 0.0002), and preoperative DHI (p < 0.0001). However, postoperative FGA did not significantly correlate with postoperative PANQOL balance or total scores (p = 0.446 and p = 0.4, respectively), or postoperative DHI (p = 0.3). Univariate analysis demonstrated that preoperative DHI and preoperative FGA were predictive of changes in postoperative PANQOL balance and total scores. However under multivariate analysis, preoperative FGA did not predict changes in postoperative PANQOL balance or total score (p = 0.24; p = 0.28, respectively). Preoperative DHI remained predictive of changes in postoperative PANQOL balance (p = 0.03) score but not of postoperative PANQOL total score (p = 0.37).
Although FGA and QOL data significantly correlated in the preoperative setting, our results did not suggest that preoperative FGA can be used to determine postoperative QOL. Additionally, the lack of correlation between FGA and QOL measurements in the acute postoperative setting suggests that further research is needed to determine contributors to postoperative QOL.
研究前庭神经鞘瘤（VS）切除前后与平衡相关的功能性步态评估（FGA）和生活质量（QOL）测量之间的关系，并评估术前 FGA 在预测术后 QOL 中的作用。
2018 年 9 月至 2019 年 12 月期间，对接受 VS 切除术的成年患者进行前瞻性临床研究。在术前 1 周和术后进行 FGA 检测。在术前和术后 3 个月进行眩晕障碍量表（DHI）和宾夕法尼亚听神经瘤生活质量量表（PANQOL）的测量。
单中心。
接受显微外科切除术的 VS 患者（年龄≥18 岁）。排除标准为既往手术或放疗的患者。
VS 切除术。
主要结局：FGA 与 QOL 调查之间的相关性。次要结局：术前平衡测量与术后 PANQOL 的相关性。
共分析了 138 例患者（平均年龄：48 岁，65.9%为女性）。最常采用经迷路入路。多变量分析显示，术前 FGA 与术前 PANQOL 平衡评分（p<0.0001）、术前 PANQOL 总分（p=0.0002）和术前 DHI（p<0.0001）显著相关。然而，术后 FGA 与术后 PANQOL 平衡或总分（p=0.446 和 p=0.4，分别）或术后 DHI（p=0.3）无显著相关性。单变量分析表明，术前 DHI 和术前 FGA 可预测术后 PANQOL 平衡和总分的变化。然而，多变量分析显示，术前 FGA 不能预测术后 PANQOL 平衡或总分的变化（p=0.24；p=0.28，分别）。术前 DHI 仍然可预测术后 PANQOL 平衡评分的变化（p=0.03），但不能预测术后 PANQOL 总分的变化（p=0.37）。
尽管 FGA 和 QOL 数据在术前有显著相关性，但我们的结果表明，术前 FGA 不能用于确定术后 QOL。此外，在急性术后环境中，FGA 与 QOL 测量之间缺乏相关性表明，需要进一步研究确定术后 QOL 的影响因素。
