Quality of life in patients with vestibular schwannomas according to management strategy

Objective: This study aimed to evaluate the quality of life of patients treated for unilateral vestibular schwannoma via observation, microsurgery, or gamma knife radiosurgery. Study Design: The study design was retrospective and cross-sectional. Methods: Patients treated for vestibular schwannoma at our institute in 2012-2013 completed a standardized questionnaire (Short Form-36) via telephone to evaluate their quality of life at least 6 months after treatment. Patients were categorized according to management (microsurgery, n=47; gamma knife radiosurgery, n=27; and observation, n=34). Clinical characteristics and quality of life were compared among the groups. Results: Tumor control rates were 94.0% in the microsurgery group and 96.2% in the radiosurgery group. The most annoying symptoms were hearing loss in the microsurgery group, dizziness in the radiosurgery group, and tinnitus in the observation group. Quality-of-life scores did not differ significantly among the three groups in four of the eight domains of the questionnaire. The microsurgery group had a significantly higher score in the general health perception domain than the other groups (p=0.003). Conclusion: Quality of life is higher after microsurgery than after radiosurgery. One specific management strategy cannot always guarantee the better quality of life. The functional status and personality traits of the patient should be considered, as well as tumor size and location when choosing a management option.