Preoperative Quality of Life in Patients with Small Vestibular Schwannomas

Vestibular schwannomas (VS) are benign tumors arising from the eighth cranial nerve. They often cause no symptoms for a long period of time. Due to the improved availability and quality of magnetic resonance imaging diagnostics, even small tumors can be diagnosed at an early stage. The fact that the diagnosis of a VS might negatively affect a patient's quality of life (QoL) should be taken into consideration when informing patients about various treatment options. However, little is known about the level of QoL in patients with small VS prior to scheduled surgery.

One hundred forty- one patients with a T1 or T2 VS that had been scheduled for microsurgery via the middle cranial fossa (MCF) approach between 01/2013 and 12/2018 were included. Quality of life was evaluated using the Short-Form-36 (SF-36) survey. Eighty-one patients completed the questionnaire. Additionally, audiological and clinical data were collected.

When compared to the German normative QoL data, VS patients showed a significant deterioration in quality of life in 6 of the 8 SF-36 subscales, whereas only 4 of 8 subscales were affected when compared to the normative group of patients with hearing loss. The analysis of predictors did not show any significant relationship between tumor volume, facial nerve function, and QoL. Only preoperative hearing status and sex had a slight impact on one subscale each (emotional health and physical health, respectively).

This study shows that patients with small VS have an impairment in QoL before surgical treatment. Most of the examined clinical predictors did not have a significant impact on the QoL.