Headache: a quality of life analysis in a cohort of 1,657 patients undergoing acoustic neuroma surgery, results from the acoustic neuroma association.
OBJECTIVE
On the basis of survey results of the Acoustic Neuroma Association (ANA), we report patient ratings of postoperative headache (POH) symptoms, determine its effect on quality of life (QOL), and review the literature regarding POH after acoustic neuroma (AN) treatment.


METHODS
In this cohort study, 1,657 patients who underwent surgical treatment of AN reported their experiences of POH.


METHODS
A detailed questionnaire was mailed to members of the ANA to identify preoperative and postoperative headache symptoms, complications, and long-term effects on physical and psychosocial function. Questions were answered by 1657 (85.4%) respondents that were intended to qualify and quantify the effects of POH, including QOL issues. Responses were analyzed by tumor size, surgical approach, and patient age and sex. Statistical analysis was performed with the SPSS software.


RESULTS
Preoperative headache was reported in approximately one third of respondents. Typical POHs occurred more than once daily (46%), lasted 1 to 4 hours in duration (43.1%), and were of moderate intensity (62.6%). The worst headaches were rated as "severe" by 77% of respondents. Treatment most often reported for typical headaches were nonprescription medications including nonsteroidal anti-inflammatory drugs in 61.3% (P < .01) and regular use of narcotics in 15%. Patients who underwent the retrosigmoid approach were significantly more likely to report their worst POH as "severe" (82.3%) compared with the translabyrinthine (75.2%) and middle fossa approaches (63.3%). Women and younger patients tended to have poorer outcomes with regard to POHs.


CONCLUSIONS
In this large cohort study of AN patients, POH was a significant morbidity among AN patients with persistent headaches. Treating physicians should be aware of the risk factors identified and the effect POH has on the QOL when counseling patients regarding optimal treatment management.
Ryzenman
John Martin
JM
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio 45267-0528, USA.
Pensak
Myles L
ML
Tew
John M
JM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015331:Cohort Studies; D035301:Cranial Fossa, Middle / Q000601:surgery; D003392:Cranial Sinuses / Q000601:surgery; D007758:Ear, Inner / Q000601:surgery; D005260:Female; D006261:Headache / Q000188:drug therapy / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000145:classification / Q000601:surgery*; D004366:Nonprescription Drugs / Q000627:therapeutic use; D011183:Postoperative Complications / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs