title: Audiovestibular Handicap and Quality of Life in Patients With Vestibular Schwannoma and "Excellent" Hearing.
abstract: Studies examining patient-reported outcomes in subjects with vestibular schwannoma (VS) and "excellent" hearing are lacking.
  
  
  
  To assess patient-reported audiovestibular handicap and overall quality of life (QoL) in VS patients with class A hearing in both ears.
  
  
  
  Among 539 VS patients treated during 1998 to 2008, we identified 296 patients with either bilateral class A (AA) hearing or 1 good ear and 1 deaf ear (AD) according to the American Academy of Otolaryngology-Head and Neck Surgery classification. Patients responded to validated hearing, tinnitus, and dizziness handicap inventories and 2 QoL questionnaires, and the 2 groups were compared. A reference group of 103 adults filled out the same questionnaires.
  
  
  
  Forty-nine patients (16.6%) had class AA and 247 patients (83.4%) had class AD hearing. AA patients scored poorer than control subjects without tumor on all handicap questionnaires ( P < .001) and a VS-specific QoL instrument ( P = .006). Con-versely, AA patients scored significantly better than patients with AD on the hearing inventory and the disease-specific QoL instrument ( P < .001), but no difference was found between these groups with regard to tinnitus and dizziness. The hearing disability score was approximately 3 times poorer for AA patients compared with control subjects without tumor; a third of AA patients reported a hearing handicap.
  
  
  
  Patients with VS and bilateral class A hearing report significantly poorer hearing handicap than control subjects without tumor but better hearing than those with unilateral deafness. When patients with bilateral class A hearing are counseled, it should be noted that one-third of patients experience self-perceived hearing handicap.
authors.affiliation: Department of Neurosurgery, Hauke-land University Hospital, Bergen, Norway.
authors.forename: Oystein Vesterli
authors.initials: OV
authors.lastname: Tveiten
authors.affiliation: Departments of Otolaryngology-Head and Neck Surgery.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Carlson
authors.affiliation: Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Link
authors.affiliation: Department of Neurosurgery, Hauke-land University Hospital, Bergen, Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Lund-Johansen
mesh_terms: D000328:Adult; D000368:Aged; D004244:Dizziness / Q000503:physiopathology; D005260:Female; D006309:Hearing / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000503:physiopathology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000503:physiopathology
keywords: Acoustic neuroma; Cerebellopontine angle; Hearing loss; Patient-reported outcome measures; Quality of life; Vestibular schwannoma