Audiovestibular factors influencing quality of life in patients with conservatively managed sporadic vestibular schwannoma.
OBJECTIVE
To measure the health-related quality of life (QoL) of patients undergoing conservative management of a vestibular schwannoma and to identify audiovestibular factors that influence health-related QoL.


METHODS
Cross-sectional case-control study.


METHODS
Adult patients undergoing conservative management of a sporadic vestibular schwannoma were identified from a prospectively updated database. Each patient was asked to complete a series of questionnaires, including the Short Form 36 health-related QoL instrument, the Hearing Handicap Inventory, the Tinnitus Handicap Inventory, and the Dizziness Handicap Inventory. The QoL data obtained were compared with UK normal data. Multiple linear regression was performed to identify audiovestibular factors influencing QoL.


METHODS
Of 241 patients still undergoing conservative management, 165 completed the questionnaires. The mean age was 66.6 years. Mean duration of follow-up was 5.7 years.


RESULTS
Physical component summary scores were significantly lower than those of the normal population. Mental component summary scores were significantly above the normal population. Regression analysis showed that dizziness handicap score and age were strong predictors of physical component summary (both p < 0.0001). Dizziness handicap score and tinnitus handicap score were significant predictors of mental component summary (p = 0.0004 and p = 0.027 respectively). However, the model only explained a small amount of the data, suggesting that there may be other factors influencing QoL.


CONCLUSIONS
Dizziness is the most significant audiovestibular predictor of QoL in patients with vestibular schwannomas. Tinnitus also has an impact on mental QoL. Hearing loss does not seem to influence QoL. Other factors such as illness perception may have an important role to play in determining QoL.
Lloyd
Simon K W
SK
University Department of Otolaryngology-Head and Neck Surgery, Central Manchester NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK. sklloyd@me.com
Kasbekar
Anand V
AV
Baguley
David M
DM
Moffat
David A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004244:Dizziness / Q000209:etiology; D005260:Female; D034381:Hearing Loss / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000209:etiology; D015837:Vestibular Diseases / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology*; D014724:Vestibular Function Tests