title: What drives quality of life in patients with sporadic vestibular schwannoma?
abstract: OBJECTIVE
  To investigate the influence of posttreatment audiovestibular symptoms, facial neuropathy, and headache on long-term quality-of-life outcomes in patients with sporadic vestibular schwannoma (VS) utilizing the Short Form 36 (SF-36) Health Survey and the Penn Acoustic Neuroma Quality of Life (PANQOL) scale.
  
  
  METHODS
  Cross-sectional observation study.
  
  
  METHODS
  Patients with sporadic small- or medium-sized VS (< 3.0 cm) who were evaluated between 1998 and 2008 at two independent tertiary academic referral centers were surveyed. Multivariable associations with the PANQOL total score and the SF-36 physical and mental component scores evaluated using regression analysis.
  
  
  RESULTS
  A total of 538 surveyed patients returned a completed questionnaire, providing a response rate of 79%. Two hundred forty-seven (46%) patients underwent stereotactic radiosurgery, 143 (27%) microsurgery, and 148 (28%) observation. Multivariable regression analysis revealed that ongoing dizziness was associated with the greatest reduction in PANQOL total score, followed by headache. After adjusting for all examined features, ongoing dizziness and ongoing headache were the only two variables that were associated with both the SF-36 physical and mental component scores. Patient sex and treatment modality did not significantly influence PANQOL or SF-36 scores.
  
  
  CONCLUSIONS
  Ongoing dizziness and headache are the strongest predictors of long-term quality-of-life reduction in patients with sporadic VS, while the impact of hearing loss, facial nerve function, and tinnitus are less by comparison. This information may be valuable for patient counseling, refinement of VS quality-of-life assessment instruments, and determining high-yield targets for therapy in efforts to further improve patient outcomes.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.|Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Carlson
authors.affiliation: Department of Neurosurgery, Haukeland University Hospital, Norway.
authors.forename: Øystein Vesterli
authors.initials: ØV
authors.lastname: Tveiten
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.|Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
authors.forename: Colin L
authors.initials: CL
authors.lastname: Driscoll
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Haukeland University Hospital, Norway.
authors.forename: Frederik K
authors.initials: FK
authors.lastname: Goplen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.|Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Neff
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Pollock
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Tombers
authors.affiliation: Department of Neurosurgery, Haukeland University Hospital, Norway.|Department of Clinical Medicine, University of Bergen, Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Lund-Johansen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.|Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Link
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000523:psychology* / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000379:methods; D011184:Postoperative Period; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Quality of life; acoustic neuroma; cerebellopontine angle; microsurgery; radiosurgery; stereotactic radiosurgery; vestibular schwannoma