Vestibular schwannoma and quality of life

Vestibular schwannoma and quality of life are interlinked when it comes to the management of patients. Quality of life (QOL), when referring to health related matters, is the way in which a patient interprets his own quality of living in daily life, related to disease or disability. It is a measure of well- being or the lack thereof. Physical, social, psychological and spiritual factors influence quality of life, which can nowadays be assessed by questionnaires.

Vestibular schwannoma and quality of life
Quality of life is important when treating patients with vestibular schwannoma.

One example of such a QOL questionnaire is the Penn Acoustic Neuroma Quality-of-Life scale (PANQOL) which is designed for patients with vestibular schwannomas. There are many publications on the QOL of life in patients with VS which shows that QOL is lower in patients with VS as in the general population. Interesting to note is that the QOL seems to be lower in patients with VS (a benign tumour) than in those with urological cancer. The reason for this is not known but the fact that there are often different options in management of VS patients may contribute to uncertainty in patients and thus a lower QOL. Another possibility is that a vestibular schwannoma is often seen as a “brain tumour” with negative correlation.

Another interesting finding is that patients with a higher emotional intelligence (EI) generally demonstrates higher QOL. EI is made up of ability emotional intelligence (AEI) and trait emotional intelligence (TEI). AEI is similar to Intelligence Quotient (IQ). TEI relates to how a person reacts and copes with pressure and demands in life, with other words predicts the impact of stress full episodes in life on a person.

In VS the QOL is applicable to three groups of patients. Patients where the tumour is observed, patients who received microsurgery and patients who received radiotherapy. There is however, very important to note, no prospective, randomized comparison between these groups to be found in the medical literature. Whereas there may be differences in the early stages (less than 5 years) after treatment the long-term QOL is the same for all three management strategies.

The most important cause for poor QOL in patients with VS is poor balance, disequilibrium and vertigo. Other factors that may determine a poor QOL are hearing loss, facial nerve dysfunction, and trigeminal nerve dysfunction. Men also tend to have a lower QOL, I wonder why?

The QOL questionnaire may in future be a used as a handy tool to assess patients with VS before a management plan is decided upon. Improving QOL in patients should be the ultimate goal.

Penn Acoustic Neuroma Quality-of-Life scale (PANQOL)