Long-Term Prospective Quality-of-Life Outcomes in 445 Patients with Sporadic Vestibular Schwannoma.

Objective: To evaluate the long-term changes in sporadic vestibular schwannoma (VS) disease-specific quality-of-life (QOL) outcomes.

Study design: Prospective longitudinal study using the Penn Acoustic Neuroma Quality of Life (PANQOL) Scale.

Setting: National survey.

Patients: Patients with sporadic VS who completed a baseline survey before treatment and at least one follow-up survey recruited through the authors' center and through the Acoustic Neuroma Association.

Interventions: Observation, microsurgery, radiosurgery.

Main outcome measures: Changes in PANQOL scores from baseline to most recent survey.

Results: Among 445 eligible patients the mean duration of follow-up was 4.4 (SD, 2.3) years, including 122, 218, and 105 in the observation, microsurgery, and radiosurgery groups, respectively. Patients managed with observation ( p = 0.03) or microsurgery ( p < 0.001) demonstrated improvement in anxiety scores. Changes in facial function scores differed significantly by management group ( p = 0.01), with patients undergoing microsurgery demonstrating a mean decline of 10 points in facial function scores compared with mean declines of 3 for those managed with observation or radiosurgery. Hearing loss scores decreased similarly over time for all three groups ( p = 0.3). There were minimal changes in total PANQOL scores over time across all management groups ( p = 0.5).

Conclusions: Long-term changes in total QOL among VS management groups are not significantly different. Microsurgery may continue to confer an advantage regarding improvement in anxiety postoperatively, but with a greater decline in facial function when compared to observation or radiosurgery. Long-term declines in hearing loss scores were not statistically significantly different among groups.