Advertisement

HNO

, Volume 65, Issue 9, pp 719–723 | Cite as

Lebensqualität von Patienten mit Vestibularisschwannom

Leitthema
  • 263 Downloads

Zusammenfassung

Hintergrund

Das Vestibularisschwannom (VS) ist eine Erkrankung, die die gesundheitsbezogene Lebensqualität („health-related quality of life“, HR-QOL) negativ beeinflussen kann. Nachdem viele Jahre nur allgemeine Lebensqualitätsmessinstrumente wie der SF-36 zur Messung der gesundheitsbezogenen Lebensqualität zur Verfügung standen, existiert seit einigen Jahren mit dem Penn Acoustic Neuroma Quality Of Life (PANQOL) ein krankheitsspezifisches Messinstrument. Es ist zu erwarten, dass die Anwendung dieses Instruments in der Zukunft wichtige Aspekte der HR-QOL bei VS besser herausarbeiten kann. Eine validierte deutsche Version des Instruments existiert noch nicht.

Die von den Patienten am häufigsten beklagten Symptome im Rahmen der Erkrankung sind Kopfschmerzen und Schwindel.

Ergebnisse und Diskussion

Die bisher vorliegende Literatur zeigt, dass die therapeutischen Verfahren die HR-QOL unterschiedlich beeinflussen. Insbesondere die Strahlentherapie hat bei kleinen und mittelgroßen Tumoren keine ausgeprägten negativen Effekte auf die HR-QOL. Die Bewertung operationsbedingter Einschränkungen gleicht sich aber über den Verlauf einiger Jahre den Bewertungen nach Strahlentherapie an. Für große VS mit einem Durchmesser >3 cm liegen diesbezüglich noch keine richtungweisenden Daten vor. Wünschenswert für die Zukunft wären prospektive Studien mit einer Langzeitnachbeobachtung von 10 Jahren und mehr, um die offenen Fragen zu klären.

Schlüsselwörter

Kopfschmerz Schwindel Fazialisparese Beobachtendes Abwarten Mikrochirurgie 

Quality of life in patients with vestibular schwannoma

Abstract

Background

Vestibular schwannoma (VS) is a disease which might affect health-related quality of life (HR-QOL) in a negative manner. For many years, only generic quality of life instruments such as SF-36 were available to measure HR-QOL. However, some years ago, the Penn Acoustic Neuroma Quality Of Life (PANQOL) tool, a disease-specific instrument, was developed and validated. It is expected that the application of this instrument will be able to better assess relevant aspects of the HR-QOL of VS patients in the future. A validated German version of the instrument does not exist yet. The disease-specific symptoms most frequently named by patients are headache and dizziness.

Results and discussion

The available literature shows that the therapeutic approaches affect HR-QOL differently. In particular, radiation therapy of small and medium-sized tumors has no pronounced negative effects on HR-QOL. However, restrictions after surgery become similar to those after radiotherapy over the course of several years. For large VS with a diameter >3 cm, no guiding data on this aspect are currently available. To clarify the outstanding issues, future prospective studies with long-term follow-up of 10 years and more are desirable.

Keywords

Headache Vertigo Facial nerve palsy Watchful waiting Microsurgery 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

I. Baumann und P. K. Plinkert geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Baumann I, Polligkeit J, Blumenstock G, Mauz PS, Zalaman IM, Maassen MM (2005) Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa approach. Acta Otolaryngol 125:585–591CrossRefPubMedGoogle Scholar
  2. 2.
    Breivik CN, Nilsen RM, Myrseth E et al (2013) Conservative management or gamma knife radiosurgery for vestibular schwannoma: tumor growth, symptoms, and quality of life. Neurosurgery 73:48–56CrossRefPubMedGoogle Scholar
  3. 3.
    Carlson ML, Tveiten OV, Driscoll CL et al (2015) Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls. J Neurosurg 122:833–842CrossRefPubMedGoogle Scholar
  4. 4.
    Carlson ML, Tveiten OV, Driscoll CL et al (2015) What drives quality of life in patients with sporadic vestibular schwannoma? Laryngoscope 125:1697–1702CrossRefPubMedGoogle Scholar
  5. 5.
    Carlson ML, Tveiten OV, Yost KJ, Lohse CM, Lund-Johansen M, Link MJ (2015) The minimal clinically important difference in vestibular schwannoma quality-of-life assessment: an important step beyond p〈 .05. Otolaryngol Head Neck Surg 153:202–208CrossRefPubMedGoogle Scholar
  6. 6.
    Cheng S, Naidoo Y, da Cruz M, Dexter M (2009) Quality of life in postoperative vestibular schwannoma patients. Laryngoscope 119:2252CrossRefPubMedGoogle Scholar
  7. 7.
    Di Maio S, Akagami R (2009) Prospective comparison of quality of life before and after observation, radiation, or surgery for vestibular schwannomas. J Neurosurg 111:855–862CrossRefPubMedGoogle Scholar
  8. 8.
    Gauden A, Weir P, Hawthorne G, Kaye A (2011) Systematic review of quality of life in the management of vestibular schwannoma. J Clin Neurosci 18:1573–1584CrossRefPubMedGoogle Scholar
  9. 9.
    Godefroy WP, Kaptein AA, Vogel JJ, van der Mey AG (2009) Conservative treatment of vestibular schwannoma: a follow-up study on clinical and quality-of-life outcome. Otol Neurotol 30:968–974CrossRefPubMedGoogle Scholar
  10. 10.
    Grauvogel J, Kaminsky J, Rosahl SK (2010) The impact of tinnitus and vertigo on patient-perceived quality of life after cerebellopontine angle surgery. Neurosurgery 67:601–609 (discussion 609–10)CrossRefPubMedGoogle Scholar
  11. 11.
  12. 12.
    Jufas N, Flanagan S, Biggs N, Chang P, Fagan P (2015) Quality of life in vestibular schwannoma patients managed by surgical or conservative approaches. Otol Neurotol 36:1245–1254CrossRefPubMedGoogle Scholar
  13. 13.
    Lloyd SK, Kasbekar AV, Baguley DM, Moffat DA (2010) Audiovestibular factors influencing quality of life in patients with conservatively managed sporadic vestibular schwannoma. Otol Neurotol 31:968–976CrossRefPubMedGoogle Scholar
  14. 14.
    McLaughlin EJ, Bigelow DC, Lee JY, Ruckenstein MJ (2015) Quality of life in acoustic neuroma patients. Otol Neurotol 36:653–656CrossRefPubMedGoogle Scholar
  15. 15.
    Myrseth E, Møller P, Wentzel-Larsen T, Goplen F, Lund-Johansen M (2006) Untreated vestibular schwannomas: vertigo is a powerful predictor for health-relatedquality of life. Neurosurgery 59:67–76 (discussion 67–76)CrossRefGoogle Scholar
  16. 16.
    Park SS, Grills IS, Bojrab D et al (2011) Longitudinal assessment of quality of life and audiometric test outcomes in vestibular schwannoma patients treated with gamma knife surgery. Otol Neurotol 32:676–679CrossRefPubMedGoogle Scholar
  17. 17.
    Pollock BE, Driscoll CLW, Link MJ et al (2006) Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery. Neurosurgery 58:77–83 (Comments 83–85)CrossRefGoogle Scholar
  18. 18.
    Prescutti L, Magnaguagno F, Pavesi G et al (2014) Combined endoscopic-microscopic approach for vestibular schwannoma removal: outcomes in a cohort of 81 patients. Acta Otorhinolaryngol Ital 34:427–433Google Scholar
  19. 19.
    Rameh C, Magnan J (2010) Quality of life of patients following stages III–IV vestibular schwannoma surgery using the retrosigmoid and translabyrinthine approaches. Auris Nasus Larynx 37:546–552CrossRefPubMedGoogle Scholar
  20. 20.
    Robinett ZN, Walz PC, Miles-Markley B, Moberly AC, Welling DB (2014) Comparison of long-term quality of life outcomes in vestibular schwannoma patients. Otolaryngol Head Neck Surg 150:1024–1032CrossRefPubMedGoogle Scholar
  21. 21.
    Ryzenman JM, Pensak ML, Tew JM Jr (2005) Facial paralysis and surgical rehabilitation: a quality of life analysis in a cohort of 1,595 patients after acoustic neuroma surgery. Otol Neurotol 26:516–521 (discussion 521)CrossRefPubMedGoogle Scholar
  22. 22.
    Ryzenman JM, Pensak ML, Tew JM Jr (2005) Headache: a quality of life analysis in a cohort of 1,657 patients undergoing acoustic neuroma surgery, results from the acoustic neuroma association. Laryngoscope 115:703–711CrossRefPubMedGoogle Scholar
  23. 23.
    Scheich M, Ginzkey C, Reuter E, Harnisch W, Ehrmann D, Hagen R (2014) Quality of life after microsurgery for vestibular schwannoma via the middle cranial fossa approach. Eur Arch Otorhinolaryngol 271:1909–1916CrossRefPubMedGoogle Scholar
  24. 24.
    Selesnick SH, Jackler RK, Pitts LW (1993) The changing clinical presentation of acoustic tumors in the MRI era. Laryngoscope 103:431–436CrossRefPubMedGoogle Scholar
  25. 25.
    Shaffer BT, Cohen MS, Bigelow DC, Ruckenstein MJ (2010) Validation of a disease-specific quality-of-life instrument for acoustic neuroma: the Penn Acoustic Neuroma Quality-of-Life Scale. Laryngoscope 120:1646–1654CrossRefPubMedGoogle Scholar
  26. 26.
    Sheth SA, Kwon CS, Barker FG II (2012) The art of management decision making: from intuition to evidence-based medicine. Otolaryngol Clin North Am 45:333–351CrossRefPubMedGoogle Scholar
  27. 27.
    Stangerup SE, Tos M, Caye-Thomasen P, Tos K, Klokker M, Thomsen J (2004) Increasing annual incidence of vestibular schwannoma and age at diagnosis. J Laryngol Otol 118:622–627CrossRefPubMedGoogle Scholar
  28. 28.
    Timmer FC, van Haren AE, Mulder JJ et al (2010) Quality of life after gamma knife radiosurgery treatment in patients with a vestibular schwannoma: the patient’s perspective. Eur Arch Otorhinolaryngol 267:867–873CrossRefPubMedGoogle Scholar
  29. 29.
    Tran Ba Huy P, Kania R, Legac MS (2008) Vestibular schwannoma (acoustic neurinoma). Natural history and quality of life. Bull Acad Natl Med 192:1725–1737 (discussion 1738–1740)PubMedGoogle Scholar
  30. 30.
    Turel MK, Thakar S, Rajshekhar V (2015) Quality of life following surgery for large and giant vestibular schwannomas: a prospective study. J Neurosurg 122:303–311CrossRefPubMedGoogle Scholar
  31. 31.
    Whitmore RG, Urban C, Church E, Ruckenstein M, Stein SC, Lee JY (2011) Decision analysis of treatment options for vestibular schwannoma. J Neurosurg 114:400–413CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Hals-Nasen-Ohren-KlinikUniversitätsklinikum HeidelbergHeidelbergDeutschland

Personalised recommendations