Vestibular Schwannomas: An Evaluation of Clinical Results and Quality of Life after Microsurgery or Gamma-Knife Radiosurgery

Material and Results: A retrospective study of 219 VS patients, non-NF 2, mean obs. time: 5.8 yrs. Tumors > 30 mm (n = 30) excluded. There were 189 patients eligible for comparative evaluation. SF-36 and Glasgow Benefit Inventory (GBI) questionnaires were sent together with a study information letter to the 168 living patients. GBI questions reflect general and psychosocial health. SF-36 questions reflect mental health (MH) and vitality (VT).

SF-36: generic indicator of health status. Normative data for Norway. GBI: Event-related questionnaire. Response rate 90%. Both questionnaires have been validated for VS.

Microsurgery: 12 patients had preoperative grade A or B hearing and preservation of hearing was intended. Three patients had postoperative grade A or B (25%). Gamma-knife: Average PTA change was −16.6 dB (+6.7 to −46.7). Fifteen patients had preserved hearing within a PTA range of 10 dB (14.5%).

A significantly higher total score in GK patients is produced by differences in the general and psychosocial sections of the questionnaire.

Conclusions: Post-treatment facial nerve function, hearing, complication rate, and QOL all were statistically significant in favor of GK treatment. The relapse rate was statistically similar. The GBI was more sensitive than the SF-36 in revealing QOL differences between the two treatment groups, and QOL showed an association with facial nerve function.