Untreated Vestibular Schwannoma: Vertigo Is a Powerful Predictor Forhealth-Related Quality of Life

Abstract

Abstract OBJECTIVE The aim of the present study was to characterise the relation between quality of life (QOL) and the four major complaints (hearing loss, tinnitus, vertigo and unsteadiness) caused by unilateral vestibular schwannoma (versus) in a cohort of well-characterised untreated patients. METHODS One hundred and ninety-nine consecutive patients (91 men, 108 women) with a mean age of 56.9 years were studied prospectively during the 4-year period 2001–2004. The average time span from symptom onset to the radiological diagnosis was 4.2 years. The patients were subject to a standardised examination including MRI, evaluation of hearing acuity, balance function by stabilometry, and a visual analogue scale (VAS) self-evaluation of tinnitus and vertigo. Furthermore, the patients responded to two questionnaires, Short-Form 36 (SF-36) and Glasgow Benefit Inventory (GBI)). A reference population was recruited from 80 adult persons who visited Haukeland University Hospital as non-patients or non-staff members. All data were recorded prospectively in a customised case report form. Statistical analysis was done with SPSS software. RESULTS The response rates of the Short-Form 36 and Glasgow Benefit Inventoryquestionnaires were 91.5 and 89.9%, respectively. According to the SF-36 questionnaire the patients scored significantly below that of expected norms with exception of physical function and mental health. Patients report negative benefit on the general and physical sections of the GBI questionnaire. Regression analysis showed that vertigo had a strong negative impact on QOL, whilst unilateral hearing loss and tinnitus had less impact on QOL. CONCLUSION Vertigo is the symptom causing the most pronounced negative effect on QOL in patients with versus The more frequent versus-symptoms unilateral hearing loss and tinnitus seem to be less important in the patients' perception of QOL evaluated by the questionnaires used in this study. If vertigo could be relieved by treatment, this symptom should be more in focus when discussing treatment options in small to medium sized versus