Romagna Alexander, Schwartz Christoph, Huffmann Beate, Hitzl Wolfgang, Kristof Rudolf A, Clusmann Hans, Blume Christian
Department of Neurosurgery, München Klinik Bogenhausen, Munich, Germany.
Department of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Sci Rep. 2025 May 7;15(1):15941. doi: 10.1038/s41598-025-00372-0.
Quality of life (QoL) is a crucial factor which has to be taken into account in the treatment of vestibular schwannomas. This study compared microsurgical and radiosurgical treatments, focusing on three. (1) evaluating post-treatment clinical outcomes, (2) assessing the effect on QoL and (3) analyzing complication rates, particularly in geriatric patients. In this retrospective study, 586 patients underwent either microsurgery or gamma knife radiosurgery between 1990 and 2013. Demographic and treatment data were collected, including quality of life (QoL) assessments using the Short Form 36 (SF-36) and evaluations of the Karnofsky Performance Status (KPS). Complication rates were also analyzed. The study included 194 microsurgery patients and 392 radiosurgery patients. Radiosurgery patients showed significantly better postoperative hearing and facial nerve function (p < 0.05). QoL scores were higher in the radiosurgery group for physical and emotional role functioning, while microsurgery patients (including aged 65 years and older) reported better scores for bodily pain and general health perceptions. Neurological complications were 41.9% in the microsurgery group, most of them being permanent (92.9%). Radiosurgery generally showed better preservation of hearing, facial nerve function, and quality of life compared to microsurgery, although both treatments appeared equally effective in older patients.
生活质量(QoL)是前庭神经鞘瘤治疗中必须考虑的关键因素。本研究比较了显微手术和放射外科治疗,重点关注三个方面:(1)评估治疗后的临床结果;(2)评估对生活质量的影响;(3)分析并发症发生率,特别是老年患者的并发症发生率。在这项回顾性研究中,1990年至2013年间,586例患者接受了显微手术或伽玛刀放射外科治疗。收集了人口统计学和治疗数据,包括使用简短健康调查问卷(SF-36)进行的生活质量(QoL)评估以及卡氏功能状态评分(KPS)评估。还分析了并发症发生率。该研究包括194例接受显微手术的患者和392例接受放射外科治疗的患者。放射外科治疗的患者术后听力和面神经功能明显更好(p < 0.05)。放射外科治疗组在身体和情感角色功能方面的生活质量评分更高,而显微手术患者(包括65岁及以上患者)在身体疼痛和总体健康感知方面的评分更高。显微手术组的神经并发症发生率为41.9%,其中大多数为永久性并发症(92.9%)。与显微手术相比,放射外科治疗通常在听力、面神经功能和生活质量的保留方面表现更好,尽管两种治疗方法在老年患者中似乎同样有效。