Acoustic neuroma: Postoperative quality of life

Objective: Evaluating patients who have had surgical management of acoustic neuroma has relied heavily on the surgeon's viewpoint for determining succ ess. However, the perspective of the surgeon may be different from that of the patient. Thus, a recent increased interest in terms of quality of life has been documented by the literature on this specific topic essentially th rough the use of a questionnaire. The objective of this paper was to review this topic in our series of patients operated on for acoustic neuroma to a scertain the personal and social impact that surgery has had on their lifes tyle. Design: This retrospective study was devoted to increasing statistics to pr ovide more detailed and valid information during the counselling phase. Methods: This study was carried out on 82 patients who underwent surgery fo r acoustic neuroma between 1988 and 1997. Each patient was recalled and ass essed for his/her postoperative quality of life. Detailed information was r equested on the initial postoperative facial, vestibular, and hearing funct ions; their evolution; and their social consequence. Finally, at the end of the interview, each patient was invited to give a final comment on his/her opinion regarding the outcomes of surgery and preoperative information. Results: Facial function showed a grade I-III in 85.4% of cases, with posto perative neurovegetative dysfunction (taste and lacrimation) in 43%. Audiol ogic abnormalities (worsening hearing and tinnitus) were complained of in 9 0% and 57% of the cases, respectively. Twenty-three percent of the patients had various degrees of gait instability; 6% reported postoperative headach e at 1-year follow-up. Social consequence (reduced work ability, vocational change, new education, state pension, etc.) was not influenced by surgery in 80%. Conclusions: Our experience is in general agreement with previously reporte d statistics. It is interesting to note that our patients exhibited more di sturbances linked to the sensory component of facial nerve. In contrast, dy sequilibrium had a less negative influence. These outcomes suggest the impo rtance of thorough preoperative counselling in candidates for surgery for a coustic neuroma in order to motivate them and, at the same time, to reduce their psychological discomfort.