• Zachary N Robinett, Patrick C Walz, Beth Miles-Markley, Aaron C Moberly, and D Bradley Welling.
• Department of Otolaryngology Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
• Otolaryngol Head Neck Surg. 2014 Jun 1; 150 (6): 1024-32.

ObjectiveTo compare long-term quality-of-life outcomes in vestibular schwannoma patients managed with observation, microsurgery, or stereotactic radiation.Study Designross-sectional survey with retrospective chart review.SettingTertiary care center.Subjects And MethodsThe Penn Acoustic Neuroma Quality of Life (PANQOL) survey was mailed to 600 patients treated for vestibular schwannoma. Patients were separated by treatment and subsequently subdivided by years of follow-up (0-5, 6-10, and >10 years). Composite quality-of-life (cQOL) scores and subscores for hearing, balance, facial nerve, pain, anxiety, energy, and general health were calculated. Scores were compared among treatment groups as a whole, among treatment groups at each time interval, and within treatment groups over time using a 2-tailed analysis of variance and paired t test.ResultsThe survey return rate was 49%, and the mean follow-up was 7.9 years. The only significant difference in cQOL occurred at 0 to 5 years, where stereotactic radiation scores were better than both microsurgery and observation (P = .009). No significant differences were detected in cQOL after 5 years. Within the radiation group, cQOL was significantly lower at 6 to 10 years than at 0 to 5 years (P = .013). At no point was cQOL for stereotactic radiation less than that for observation or microsurgery.ConclusionsLong-term (>5 years) quality-of-life outcomes measured by the PANQOL in vestibular schwannoma patients show no significant differences between stereotactic radiation, observation, and microsurgical intervention. Studies are needed to fully evaluate very-long-term QOL for patients with vestibular schwannoma.© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

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