Nikolopoulos T P, Johnson I, O'Donoghue G M
Department of Otorhinolaryngology, Queen's Medical Center, University Hospital, Nottingham, United Kingdom.
Laryngoscope. 1998 Sep;108(9):1382-5. doi: 10.1097/00005537-199809000-00024.
To assess how surgery affected the quality of life of patients with acoustic neuromas and to investigate possible predictors of the functional outcome following surgery.
A questionnaire based on the Glasgow Benefit Inventory was completed by patients randomly selected following acoustic neuroma surgery.
Skull base surgery unit of a university teaching hospital (tertiary referral center).
Fifty-three patients with acoustic tumors (follow-up, 1 to 3 y).
With regard to overall quality of life, nine patients (17.4%) reported that it became better, 28 patients (53.8%) worse, and 15 patients (28.8%) that it remained the same. Four patients (7.8%) became better off financially, 15 patients (29.4%) worse, and 32 (62.8%) remained unchanged. Forty-one patients (78.8%) did not change their occupation, and 11 (21.2%) had to change their occupation, mainly because of the adverse effects of the operation. With regard to the age at operation, older patients were found to have better overall quality of life. Moreover, younger patients had worse postoperative financial status and they were more likely to change their occupation after the operation. The tumor size did not significantly affect the overall postoperative quality, but it did affect the postoperative financial status (patients with larger tumors were more likely to have worse postoperative financial status).
Acoustic neuroma surgery has a significant impact on patients' overall quality of life. Surgeons proposing to operate on small tumors should not assume that the impact on patients' life will be necessarily less than that following the removal of larger tumors. All patients, especially in the younger age group, should be prepared and thoroughly informed about the consequences of the operation on their quality of life.
评估手术如何影响听神经瘤患者的生活质量,并调查手术后功能结果的可能预测因素。
对听神经瘤手术后随机选取的患者进行基于格拉斯哥效益量表的问卷调查。
一所大学教学医院(三级转诊中心)的颅底外科。
53例听神经瘤患者(随访1至3年)。
关于总体生活质量,9例患者(17.4%)报告生活质量变好,28例患者(53.8%)变差,15例患者(28.8%)生活质量保持不变。4例患者(7.8%)经济状况改善,15例患者(29.4%)变差,32例患者(62.8%)不变。41例患者(78.8%)未改变职业,11例患者(21.2%)不得不改变职业,主要是因为手术的不良影响。关于手术时的年龄,发现年龄较大的患者总体生活质量较好。此外,年轻患者术后经济状况较差,术后更有可能改变职业。肿瘤大小对术后总体质量没有显著影响,但确实影响术后经济状况(肿瘤较大的患者术后经济状况更有可能较差)。
听神经瘤手术对患者的总体生活质量有重大影响。建议对小肿瘤进行手术的外科医生不应认为对患者生活的影响必然小于切除较大肿瘤后的影响。所有患者,尤其是年轻患者群体,都应做好准备并充分了解手术对其生活质量的影响。