{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:23:27Z","timestamp":1774520607114,"version":"3.50.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Health-related quality of life (HRQoL) is a key outcome in the management of vestibular schwannoma (VS). Although wait-and-scan (W&amp;S), stereotactic radiosurgery (SRS), and microsurgery (MS) are established management strategies, their comparative effects on HRQoL remain unclear. This systematic review and meta-analysis aimed to synthesize HRQoL outcomes using the Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire and to pool PANQOL scores for W&amp;S, SRS, and MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed and Embase was conducted up to February 2025. Eligible studies included patients with unilateral sporadic VS managed with W&amp;S, SRS, or MS, with HRQoL assessed by PANQOL at least one year after diagnosis or intervention. Pooled mean PANQOL scores were calculated using single-arm meta-analyses. Minimal clinically important differences (MCIDs) were applied to assess relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      16 studies including 3745 patients were analyzed. The pooled PANQOL total score was 69.1 (95% CI 66.0\u201372.2) for W&amp;S (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,430), 66.9 (95% CI 62.7\u201371.2) for SRS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009864), and 61.3 (95% CI 57.2\u201365.4) for MS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091451). Across domains, scores were the lowest for hearing and energy and the highest for facial function and anxiety. None of the between-strategy differences in total or domain scores exceeded established MCID thresholds. Substantial heterogeneity was present across all analyses (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009&gt;\u200975%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with unilateral VS report broadly comparable HRQoL following W&amp;S, SRS, or MS. Although numerical differences in PANQOL scores exist, they are not clinically meaningful. The observed heterogeneity highlights the need for standardized, prospective studies and international collaboration to better inform patient-centered decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-13730-3","type":"journal-article","created":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T18:43:09Z","timestamp":1772908989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health-related quality of life in patients with vestibular schwannoma managed with observation, stereotactic radiosurgery or microsurgery: a systematic review and single-arm meta-analysis"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9439-5626","authenticated-orcid":false,"given":"Ineke M. J.","family":"Pruijn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9rique R. L. 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