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. 2023 Feb 1;44(2):161-167.
doi: 10.1097/MAO.0000000000003773. Epub 2022 Nov 29.

Vestibular Complaints Impact on the Long-Term Quality of Life of Vestibular Schwannoma Patients

Constanza Fuentealba-Bassaletti  1 , Olaf M Neve  1 , Babette F van Esch  1 , Jeroen C Jansen  1 , Radboud W Koot  2 , Peter Paul G van Benthem  1 , Erik F Hensen  1
Affiliations

Vestibular Complaints Impact on the Long-Term Quality of Life of Vestibular Schwannoma Patients

Constanza Fuentealba-Bassaletti et al. Otol Neurotol. .

Abstract

Objective: To analyze the effect of dizziness-related symptoms on the long-term quality of life (QoL) of patients with unilateral vestibular schwannoma.

Methods: In this cross-sectional study, patients with a unilateral vestibular schwannoma diagnosed between 2004 and 2013 completed a disease-specific QoL questionnaire (Penn Acoustic Neuroma Quality of Life [PANQOL]) and the Dizziness Handicap Inventory (DHI) in 2020. Linear regression was performed to assess the correlation between QoL and the DHI total score, and the scores of the DHI functional, emotional, and physical subdomains. Potential confounders such as age, sex, tumor size at baseline, and treatment modality (active surveillance, surgery, or radiotherapy) were included in the model.

Results: In total, 287 of 479 patients (59%) experienced dizziness with a median follow-up of 10 years. The DHI total score was significantly associated with the PANQOL total score. On average, we found a reduction of 0.7 points on the PANQOL for each additional point on the DHI. The DHI emotional subdomain was the most prominent determinant of poorer QoL. Each point on the DHI emotional subscale was associated with a reduction of 1.3 on the PANQOL score. Treatment modality did not have a clinically relevant effect on dizziness-related QoL.

Conclusions: Even mild dizziness can have a significant and clinically relevant effect on the QoL of patients with unilateral vestibular schwannoma in the long term. This holds true for all treatment modalities. Addressing the vestibular problems may improve QoL in vestibular schwannoma patients, and DHI subscale analysis may help tailor the optimal vestibular intervention.

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Conflict of interest statement

The authors disclose no conflicts of interest.

Figures

FIG. 1
FIG. 1
Flowchart of study participants.
FIG. 2
FIG. 2
DHI severity categories related to QoL total scores. From the 304 patients who completed both the PANQOL and the DHI, the patients with severe complaints (36.5 ± 13.5) have significant worse QoL scores than patients with mild vestibular complaints (72.2 ± 13.3). DHI indicates Dizziness Handicap Inventory; QoL, quality of life; PANQOL, Penn Acoustic Neuroma Quality of Life.
FIG. 3
FIG. 3
DHI subscales scores related to PANQOL total scores. The emotional subscale has the strongest association with QoL (−1.3; 95% CI, −1.6 to −1.0) compared with the functional (−0.6; 95% CI, −0.9 to −0.3) and the physical subscale (−0.1; 95% CI, −0.4 to 0.2). Light gray line represents emotional subscale; gray line, functional subscale; and black line, physical subscale. CI indicates confidence interval; DHI, Dizziness Handicap Inventory; QoL, quality of life; PANQOL, Penn Acoustic Neuroma Quality of Life.
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