Hearing Loss and Balance Dysfunction are the Major Causes for Diminished Work Capacity after Surgery for Vestibular Schwannomas

• Main Authors: Kahlon, Babar, Siesjö, Peter, Magnusson, Måns, Lindberg, Sven, Karlberg, Mikael
• Format: Conference Proceeding
• Language: English
• ISSN: 1531-5010; 1532-0065
• DOI: 10.1055/s-2007-984007

Introduction: Morbidity in patients surgically treated for vestibular schwannomas has diminished during the last 25 years due to improvements in operative technique, preoperative management, and postoperative care. Still, some patients are incapacitated for shorter or longer periods after treatment. In order to reveal the reasons for this we extracted data from a retrospective questionnaire sent to all patients who had undergone surgery for vestibular scwhannomas during a 22-year period. Methods: All patients (n = 485) consecutively operated for vestibular schwannoma between 1979 and 2000 were retrospectively researched. Fifty-five patients were excluded (deceased = 53; not traced = 2). A questionnaire was sent to 430 patients to find out about their postoperative health and functional status. Results: Ninety-three percent (398) of the patients responded [188 males (47%) and 210 females (53%)]. Mean follow-up time ranged from 1 to 22 years. Three hundred (75%) were operated with a translabyrinthine, 87 (22%) with a retrosigmoid, and 11 (3%) with a middle fossa approach. Ninety-four percent of the patients reported a total hearing loss. Ninety-eight percent reported total hearing loss in the TL group compared to 84% in the SO group. Thirty-four percent reported hearing loss to be the most disturbing deficit. Thirty-two percent reported hearing loss to be the main reason they were forced to either abandon or reduce their previous work. Thirty-four percent reported better balance function at long-term follow-up compared with their preoperative status. Twenty-four percent reported balance disturbance to be the most disturbing deficit. Twenty-three percent of the patients reported that they had to either abandon or reduce their previous work due to balance dysfunction. No difference in long-time result was seen in the group of patients operated with TL or SO approach. In a subgroup of patients older than 70 years, balance disturbance was more common. Seventy-five percent of the patients had reduced facial movement immediately postoperatively. Thirty-nine percent reported subjectively they were totally normal at long-term follow-up. Many more reported improvement of various degrees. Fourteen percent reported facial dysfunction to be the most disturbing deficit. Conclusion: Hearing loss and balance dysfunction were reported to be the most troublesome deficits in the patients' daily living and were also the most common cause for the patients to abandon or reduce t