title: Quality of life following surgery for large and giant vestibular schwannomas: a prospective study.
abstract: OBJECTIVE
  Prospective studies of quality of life (QOL) are infrequently performed in patients undergoing surgery for vestibular schwannoma (VS). The authors designed this to study to investigate health-related QOL (HR-QOL) in patients with large and giant VSs before and after surgery.
  
  
  METHODS
  Between January 2009 and December 2012, HR-QOL was measured prospectively before and after surgery, using the 36-Item Short Form Health Survey (SF-36), in 100 patients who underwent surgery for unilateral large or giant VS (tumor size≥3 cm). The Glasgow Benefit Inventory (GBI) was also used to evaluate the effect of surgery.
  
  
  RESULTS
  A total of 100 patients were included in the study (65 men and 35 women). Their mean age (±SD) was 44.2±11.5 years. The preoperative QOL was decreased in all SF-36 domains. A 1-year follow-up evaluation was conducted for all patients (mean 13.5±5.3 months after surgery). The results showed an improvement in HR-QOL compared with preoperative status in all cases, with 63%-85% of patients showing a minimum clinically important difference (MCID) in various domains. A second follow-up evaluation was performed in 51 cases (mean time after surgery, 29.0±8.3 months) and showed sustained improvement in SF-36 scores. In some domains there was further improvement beyond the first follow-up. On the GBI, 87% of patients reported improvement, 1% felt no change, and 12% of patients reported deterioration.
  
  
  CONCLUSIONS
  Patients harboring large or giant VSs score lower on all the QOL domains compared with the normative population. More than 60% showed a clinically significant improvement in HR-QOL 1 year after surgery, a result that was sustained at subsequent follow-up.
authors.affiliation: Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Mazda K
authors.initials: MK
authors.lastname: Turel
authors.forename: Sumit
authors.initials: S
authors.lastname: Thakar
authors.forename: Vedantam
authors.initials: V
authors.lastname: Rajshekhar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006304:Health Status; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: CN = cranial nerve; GBI = Glasbow Benefit Inventory; Glasgow Benefit Inventory; HR-QOL = health-related QOL; MCID = minimum clinically important difference; QOL = quality of life; SEM = standard error of measurement; SF=36 = 36-Item Short Form Health Survey; Short-Form 36; VS = vestibular schwannoma; brain tumor; oncology; quality of life; surgery