Long-Term Quality of Life in Patients with Intracanalicular Vestibular Schwannomas after Gamma Knife Surgery Treatment: A Follow-Up Study

Abstract

Introduction. Our previous research showed that the gamma knife surgery (GKS) is a highly effective treatment for intracanalicular vestibular schwannomas (IVS). In the current study, we aimed to evaluate long-term quality of life (QoL) as a follow-up to the assessment of baseline clinical and demographic parameters in the original study. Moreover, QoL outcomes were compared with norms for the general population and for patients who underwent different ear, nose, and throat (ENT) procedures. Materials and Methods. The follow-up study included 92 patients (59 women and 33 men; mean age, 61.71 ± 12.55 years; range: 32-85 years) with unilateral IVS who underwent GKS. Patients completed the Assessment of Quality of Life, Penn Acoustic Neuroma Quality-of-Life, Glasgow Benefit Inventory, and WHO-5 Well-being Index questionnaires as well as a demographic survey. Neurosurgical parameters were assessed using the Koos and House-Brackmann scales and the results of audiological examinations. Results and Conclusions. QoL scores were within or above the norm in 38% of patients. There were significant differences in terms of comorbidities and emotional well-being between patients with QoL scores within or above the norm and patients with QoL scores below the norm. Comorbidities were more common in patients with QoL scores below the norm, and they influenced reported QoL (p = 0.009). Patients with QoL scores within or above the norm reported better emotional well-being than those with QoL scores below the norm. Long-term QoL outcomes were satisfactory, consistent with the results of the original study. Although GKS is a complex procedure, patients reported higher QoL than those using hearing aids and the same QoL as those after ENT surgery or reassurance. However, they reported a slightly lower QoL than patients taking ENT medications. GKS appears to be a promising treatment option for patients with IVS.