Quality of life after acoustic neuroma surgery.

OBJECTIVE: The aim of this study is to assess patients' quality of life after acoustic neuroma surgery, and if some patients' characteristics, parameters of tumor and surgical parameters affect patients' quality of life. STUDY DESIGN: Retrospective study. SETTING: Tertiary care center. PATIENTS: A group of 386 patients who underwent acoustic neuroma surgery. INTERVENTION: Patients included were derived from a population of 459 subjects operated for acoustic neuroma by the Otologic Group of Piacenza. MEAN OUTCOME MEASURE: The outcome of the questionnaires on quality of life (SF 36), the Dizziness Handicap Inventory (DHI) and a questionnaire of patients' histories were analyzed. RESULTS: In our sample a group of 231 patients were asymptomatic after surgery, while 155 patients reported very really disabling symptoms. Hearing loss was perceived as the most disabling symptom. The scores of questionnaire on quality of life were lower than scores for the normal population. The indices of disablement influenced the perception of quality of life. CONCLUSION: Our study has shown that patients perceived a worsening of their quality of life, in particular women and patients over 45. Surgery caused a higher percentage of disability. Patients' quality of life can be used as a parameter for the timing of surgery. Our data indicate that an early surgical approach for intrameatal tumor is better than waiting for an increase in the tumor size. A "wait-and-scan" strategy for extrameatal neuromas which do not affect the brainstem is preferable, since these patients have a worsening of their quality of life after surgery independently of the tumor size.