Functional Results and Quality of Life after Extirpation of Vestibular Schwannoma

Introduction: The aim of the study was to evaluate the postoperative hearing and facial nerve function and the quality of life (QL) after removal of vestibular schwannomas (VS). Material and Methods: In a retrospective study 125 patients with a VS were analyzed. Forty-one patients of this group who had been operated through the enlarged middle fossa approach (EMFA) were also examined by a psychologist for evaluation of QL. For this purpose the SIP (Sickness Impact Profile) questionnaire was used to determine the neuropsychological functions and signs of affective disturbances. Results: Fifty-four patients (43%) had a type-A stadium, 47 (38%) had a type-B, and 24 (19%) had a type-C stadium. Twenty-nine patients were operated through the translabyrinthine approach, 89 through the EMFA, and 7 through the retrosigmoid approach in cooperation with neurosurgeons. On average, the follow-up time was 57 months. In 53% of cases the hearing function could be preserved. Fifty percent of patients suffered long-term depression and/or memory disturbance. The subjective QL was expressed through depression and social withdrawal associated with deafness. Surprisingly, the facial nerve function had no significant effect on QL. Conclusion: Our functional results concerning postoperative hearing level and facial nerve function are comparable with other studies. The cognitive and affective disturbances maybe due to the elevation of the temporal lobe during surgery. Further research, especially in the preoperative examination of QL and the psychological state, are recommended.