Scheich Matthias, Schultes Lisa, Stöth Manuel, Krannich Jens-Holger, Hagen Rudolf, Hackenberg Stephan, Bürklein Miriam
Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany.
Department of Human Resources, University Hospital of Würzburg, Würzburg, Germany.
J Int Adv Otol. 2024 Nov 25;20(6):472-476. doi: 10.5152/iao.2024.241481.
Vestibular schwannomas (VS) are benign tumors arising from the eighth cranial nerve. They often cause no symptoms for a long period of time. Due to the improved availability and quality of magnetic resonance imaging diagnostics, even small tumors can be diagnosed at an early stage. The fact that the diagnosis of a VS might negatively affect a patient's quality of life (QoL) should be taken into consideration when informing patients about various treatment options. However, little is known about the level of QoL in patients with small VS prior to scheduled surgery.
One hundred forty- one patients with a T1 or T2 VS that had been scheduled for microsurgery via the middle cranial fossa (MCF) approach between 01/2013 and 12/2018 were included. Quality of life was evaluated using the Short-Form-36 (SF-36) survey. Eighty-one patients completed the questionnaire. Additionally, audiological and clinical data were collected.
When compared to the German normative QoL data, VS patients showed a significant deterioration in quality of life in 6 of the 8 SF-36 subscales, whereas only 4 of 8 subscales were affected when compared to the normative group of patients with hearing loss. The analysis of predictors did not show any significant relationship between tumor volume, facial nerve function, and QoL. Only preoperative hearing status and sex had a slight impact on one subscale each (emotional health and physical health, respectively).
This study shows that patients with small VS have an impairment in QoL before surgical treatment. Most of the examined clinical predictors did not have a significant impact on the QoL.
前庭神经鞘瘤(VS)是起源于第八颅神经的良性肿瘤。它们通常在很长一段时间内不引起症状。由于磁共振成像诊断的可用性和质量提高,即使是小肿瘤也能在早期被诊断出来。在告知患者各种治疗选择时,应考虑VS的诊断可能对患者生活质量(QoL)产生负面影响这一事实。然而,对于计划手术前小VS患者的生活质量水平知之甚少。
纳入2013年1月至2018年12月期间计划通过中颅窝(MCF)入路进行显微手术的141例T1或T2期VS患者。使用简短健康调查量表(SF-36)评估生活质量。81例患者完成了问卷调查。此外,还收集了听力学和临床数据。
与德国正常生活质量数据相比,VS患者在SF-36的8个分量表中的6个中生活质量显著下降,而与听力损失患者的正常组相比,8个分量表中只有4个受到影响。预测因素分析未显示肿瘤体积、面神经功能和生活质量之间存在任何显著关系。只有术前听力状况和性别分别对一个分量表(情绪健康和身体健康)有轻微影响。
本研究表明,小VS患者在手术治疗前生活质量受损。大多数检查的临床预测因素对生活质量没有显著影响。