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Long-term quality of life after surgery for cerebellopontine angle epidermoid cysts: a cross-sectional study
Anselmi Kovalainen1,2, Justiina Huhtakangas1, Harri Sintonen3
1Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, Uusimaa, Finland.
Introduction:
Cerebellopontine angle epidermoid cysts (CPA EC) are rare, benign tumors, which envelop neurovascular structures during their slow growth. Cranial nerve deficits are common in pre- and postoperative phases, and repeated surgery is often needed due to recurrences.
Research Question:
What is the effect of CPA EC and its surgery on HRQoL?
Materials And Methods:
We conducted a cross-sectional study of consecutive patients surgically treated for CPA epidermoid cysts at a single center between 1975 and 2022. HRQoL was assessed using a self-administered survey consisting of the 15D instrument, alongside clinical and demographic data. Results were compared to an age-, sex-, and region-matched general population sample.
Results:
Of eligible patients, 18/19 (95 %) responded. Median follow-up was 17 years (range 2-48 years). Most patients (78 %) reported persistent symptoms related to CPA EC surgery, notably hearing loss (50 %) and balance issues (50 %). The mean 15D score in the patient cohort was lower than in the general population (difference = 0.037; p = 0.28) representing a clinically important, though statistically non-significant, difference. Usual daily activities (difference = 0.13; p = 0.054) and hearing (difference = 0.084; p = 0.080) were most decreased. Functional independence remained high, with all patients ambulatory (mRS ≤3), and 50 % reported full function (mRS 0).
Discussion And Conclusion:
Patients surgically treated for CPA epidermoid cysts have a long-term reduction in HRQoL compared to the general population, particularly in domains of day-to-day activities and hearing. While most patients report persistent symptoms, half consider having a normal functional status.
