Quality of life after acoustic neuroma surgery

A questionnaire was sent to 134 patients who had undergone surgery for a unilateral acoustic neuroma between 1980 and 1993, to obtain data on the consequences on their quality of life, physical condition, social life, employment, and use of medical facilities. Distinctions were made between the translabyrinthine-transotic approach, the suboccipital approach, the tumor size, and the number of operations per patient. We found that the patients' reported state of health after surgery was poorer than that in a group of comparable nonoperated patients. Recuperation after an operation took many months and did not always result in full recovery. Surgery had various effects on preoperative symptoms such as hearing loss, tinnitus, vertigo, and facial nerve dysfunction: improvement, no change, or deterioration. Surgery had severe consequences on social life and occupation, but far less effect on income. Almost one third of the patients required postoperative home help, and a proportion were declared unfit to work. The surgical approach, tumor size, and reoperations had a definite influence on the study parameters. After suboccipital surgery, there were more reports of pain, more declarations of incapacity to work, poorer facial nerve function, and more frequent visits to the general practitioner. The translabyrinthine-transotic approach was associated with more severe pain and more complaints of postoperative vertigo. A greater proportion of the patients with larger tumors were declared unfit to work. The general state of health after suboccipital reoperations was better than after the initial operation; there was no reasonable explanation for this. Facial nerve function deteriorated after reoperation(s).