{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:34:36Z","timestamp":1792510476482,"version":"4.5.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The best management strategy for small-to medium-sized vestibular schwannomas (VSs) remains controversial between observation, radiation, and microsurgical resection (surgery). The authors undertook a prospective observational cohort study comparing all 3 therapeutic modalities in patients with VSs, focusing on quality of life (QOL) outcomes.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>All patients in the study completed the 36-Item Short Form Health Survey at regular intervals, with a mean follow-up of 31.8 months. Two hundred five (77.7%) of 264 patients completed questionnaires, including 47 who underwent observation, 48 who received either linear accelerator radiosurgery or fractionated radiotherapy (radiation group), and 134 who underwent surgery (of whom 37 had tumors &gt; 3 cm in diameter). Patients allocated to the observation group had smaller tumors than those in the other groups (mean 1.3 cm; p &lt; 0.001). Patients who received radiation were older than patients in the other groups (mean 60.0 years; p &lt; 0.001).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>There were no baseline QOL differences between the observation, radiation, and surgery (tumors \u2264 3 cm) groups. Quality of life remained unchanged for the observation and radiation groups throughout the follow-up period. In the surgery group with tumors \u2264 3 cm, a significant improvement in total score and composite mental dimension was observed at 24 months. In the surgery group with tumors &gt; 3 cm, there was an early improvement in composite mental dimension at 1.5 months, as well as at 24 months; total score and composite physical dimension were improved at 24 months in this group as well.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Based on the current management protocol, patients with VSs enjoy similar QOL throughout the follow-up period after undergoing observation, radiation therapy, or surgery.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2008.10.jns081014","type":"journal-article","created":{"date-parts":[[2009,3,20]],"date-time":"2009-03-20T13:55:38Z","timestamp":1237557338000},"page":"855-862","source":"Crossref","is-referenced-by-count":85,"title":["Prospective comparison of quality of life before and after observation, radiation, or surgery for vestibular schwannomas"],"prefix":"10.3171","volume":"111","author":[{"given":"Salvatore","family":"Di Maio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryojo","family":"Akagami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1 Suppl","key":"b1-1110855","series-title":"Neurosurgery","first-page":"78","article-title":"Localized transcranial electrical motor evoked potentials for monitoring cranial nerves in cranial base surgery","volume":"57","author":"Akagami","year":"2005"},{"key":"b2-1110855","series-title":"Acta Otorrinolaringol Esp","first-page":"61","article-title":"[Quality of life following vestibular schwannoma surgery.]","volume":"58","author":"Alfonso","year":"2007"},{"key":"b3-1110855","series-title":"Am J Otol","first-page":"421","article-title":"Evaluation of quality of life and symptoms after translabyrinthine acoustic neuroma surgery","volume":"18","author":"Andersson","year":"1997"},{"key":"b4-1110855","series-title":"Ann Otolaryngol Chir Cervicofac","first-page":"83","article-title":"[Postoperative quality of life for patients with a vestibular schwannoma]","volume":"121","author":"Barre","year":"2004"},{"key":"b5-1110855","series-title":"Acta Otolaryngol","first-page":"585","article-title":"Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa approach","volume":"125","author":"Baumann","year":"2005"},{"key":"b6-1110855","series-title":"J Neurosurg","first-page":"818","article-title":"Self-assessed quality of life after acoustic neuroma surgery","volume":"99","author":"Betchen","year":"2003"},{"key":"b7-1110855","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1116","article-title":"Audiologic and treatment outcomes after linear accelerator based stereotactic irradiation for acoustic neuroma","volume":"59","author":"Chung","year":"2004"},{"key":"b8-1110855","series-title":"Laryngoscope","first-page":"151","article-title":"Postoperative quality of life in vestibular 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C: Acoustic neuroma surgery: outcome analysis of patient-perceived disability","volume":"18","author":"Rigby","year":"1997"},{"key":"b29-1110855","series-title":"Otol Neurotol","first-page":"516","article-title":"Facial paralysis and surgical rehabilitation: a quality of life analysis in a cohort of 1,595 patients after acoustic neuroma surgery","volume":"26","author":"Ryzenman","year":"2005"},{"key":"b30-1110855","series-title":"Laryngoscope","first-page":"703","article-title":"Headache: a quality of life analysis in a cohort of 1,657 patients undergoing acoustic neuroma surgery, results from the acoustic neuroma association","volume":"115","author":"Ryzenman","year":"2005"},{"key":"b31-1110855","series-title":"Evidence-Based Medicine: How to Practice and Teach EBM","author":"Sackett","year":"2000"},{"key":"b32-1110855","series-title":"Clin Otolaryngol","first-page":"621","article-title":"Quality of life following microsurgery, radiosurgery and conservative management for unilateral vestibular schwannoma","volume":"29","author":"Sandooram","year":"2004"},{"key":"b33-1110855","series-title":"Otol Neurotol","first-page":"547","article-title":"The natural history of vestibular schwannoma","volume":"27","author":"Stangerup","year":"2006"},{"key":"b34-1110855","series-title":"J Laryngol Otol","first-page":"955","article-title":"Long-term socio-economic impact of vestibular schwannoma for patients under observation and after surgery","volume":"117","author":"Tos","year":"2003"},{"key":"b35-1110855","series-title":"Acta Otolaryngol","first-page":"600","article-title":"Patients' fears, expectations and satisfaction in relation to management of vestibular schwannoma: a comparison of surgery and observation","volume":"123","author":"Tos","year":"2003"},{"key":"b36-1110855","series-title":"Otol Neurotol","first-page":"403","article-title":"Quality of life after acoustic neuroma surgery","volume":"27","author":"Tufarelli","year":"2006"},{"key":"b37-1110855","series-title":"Ann Otol Rhinol Laryngol","first-page":"423","article-title":"Quality of life after acoustic neuroma surgery","volume":"105","author":"van Leeuwen","year":"1996"},{"key":"b38-1110855","series-title":"Med Care","first-page":"473","article-title":"CD: The MOS 36-Item short-form health survey (SF-36). 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