A Hotchkies, E Heward, A Wadeson, C Heal, S R Freeman, S A Rutherford, A T King, O Pathmanaban, J Halliday, G Whitfield, C McBain, R J Colaco, T Campbell, S J Goh, S K W Lloyd
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引用次数: 0
Abstract
Objective: Management options for vestibular schwannoma include microsurgery (MS), stereotactic radiosurgery (SRS), and watch, wait, and rescan (WWR). This study aimed to evaluate changes in patient and disease-specific quality of life (QoL) outcomes over time, comparing each treatment modality in a matched cohort.
Methods: A prospective cohort study recruited adult patients with sporadic vestibular schwannomas ≤ 3 cm in size undergoing treatment between January 2012 and April 2022 in a single tertiary referral center. Questionnaires were completed at diagnosis and ≥ 12 months posttreatment to assess patient-reported changes in QoL (Hearing, Dizziness, Tinnitus Handicap Inventories; Penn Acoustic Neuroma QoL questionnaire (PANQOL) and the Short Form-36 QoL questionnaire (SF-36)).
Results: In total, 124 patients returned completed questionnaires (MS: 42, SRS: 42, WWR 40). The SRS group had a clinically significant deterioration in their hearing scores posttreatment (p = 0.002). Dizziness scores worsened in the MS and WWR groups posttreatment; this did not reach clinical significance. Hearing deterioration was identified in the WWR group over time using the PANQOL domain (p = 0.012). The SF-36 questionnaire showed a significant deterioration in physical functioning, role limitations, and component summary for SRS patients posttreatment (p = 0.0018, p = 0.0032, p = 0.0308). No other significant differences were seen in disease-specific or general QoL domains when comparing treatment strategies.
Conclusion: Outcomes in similar disease-specific domains were not consistent across questionnaires. All three treatment modalities appear to result in comparable long-term disease-specific QoL outcomes. These findings will enable evidence-based patient counseling to inform decision-making.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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