Outcome Measures and Quality of Life in Vestibular Schwannomas

Abstract

This review summarizes existing vestibular schwannoma (VS) disease-specific and non-disease-specific patient-reported outcome measure (PROM) tools for quality of life (QoL) and audio-vestibular symptoms, compares QoL across treatment modalities, and discusses the potential role of psychological variables in QoL and recovery after surgical resection of VS. VS treatment success was previously assessed according to various factors such as the extent of tumor resection, facial nerve function, and hearing preservation. However, the literature demonstrates recent shifts away from using such physician-reported “objective” outcomes as benchmarks for success towards more patient-perceived “subjective” measures. A number of PROM tools have been developed to assess QoL and other measures in patients with VS. This has allowed us to better understand and quantify the impact of the disease and of the treatments on our patient population. However, there are important considerations to be made when applying PROM in clinical settings such as understanding the concept of Minimal Clinically Important Difference (MCID). The use of disease-specific PROMs, such as the PANQOL, as a primary outcome in VS research is encouraged. When doing so, PROM scales should incorporate the concept of MCID to distinguish statistically significant from clinically significant findings and should further investigate the role of non-medical variables, such as psychological variables, on QoL and recovery trajectories in patients with VS. Actual literature does not seem to indicate a clinically significant difference in patient-reported outcomes among treatment modalities.