{"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":1792510476799,"version":"4.5.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,4]]},"abstract":"\n OBJECT<\/jats:title>\n The optimal treatment for sporadic vestibular schwannoma (VS) is highly controversial. To date, the majority of studies comparing treatment modalities have focused on a narrow scope of technical outcomes including facial function, hearing status, and tumor control. Very few publications have investigated health-related quality of life (HRQOL) differences between individual treatment groups, and none have used a disease-specific HRQOL instrument.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n All patients with sporadic small- to medium-sized VSs who underwent primary microsurgery, stereotactic radiosurgery (SRS), or observation between 1998 and 2008 were identified. Subjects were surveyed via postal questionnaire using the 36-Item Short Form Health Survey (SF-36), the 10-item Patient-Reported Outcomes Measurement Information System short form (PROMIS-10), the Glasgow Benefit Inventory (GBI), and the Penn Acoustic Neuroma Quality-of-Life (PANQOL) scale. Additionally, a pool of general population adults was surveyed, providing a nontumor control group for comparison.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 642 respondents were analyzed. The overall response rate for patients with VS was 79%, and the mean time interval between treatment and survey was 7.7 years. Using multivariate regression, there were no statistically significant differences between management groups with respect to the PROMIS-10 physical or mental health dimensions, the SF-36 Physical or Mental Component Summary scores, or the PANQOL general, anxiety, hearing, or energy subdomains. Patients who underwent SRS or observation reported a better total PANQOL score and higher PANQOL facial, balance, and pain subdomain scores than the microsurgical cohort (p < 0.02). The differences in scores between the nontumor control group and patients with VS were greater than differences observed between individual treatment groups for the majority of measures.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The differences in HRQOL outcomes following SRS, observation, and microsurgery for VS are small. Notably, the diagnosis of VS rather than treatment strategy most significantly impacts quality of life. Understanding that a large number of VSs do not grow following discovery, and that intervention does not confer a long-term HRQOL advantage, small- and medium-sized VS should be initially observed, while intervention should be reserved for patients with unequivocal tumor growth or intractable symptoms that are amenable to treatment. Future studies assessing HRQOL in VS patients should prioritize use of validated disease-specific measures, such as the PANQOL, given the significant limitations of generic instruments in distinguishing between treatment groups and tumor versus nontumor subjects.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.11.jns14594","type":"journal-article","created":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T10:00:38Z","timestamp":1420192838000},"page":"833-842","source":"Crossref","is-referenced-by-count":208,"title":["Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls"],"prefix":"10.3171","volume":"122","author":[{"given":"Matthew L.","family":"Carlson","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology-Head and Neck Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oystein Vesterli","family":"Tveiten","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin L.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology-Head and Neck Surgery and"},{"name":"Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota;\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik K.","family":"Goplen","sequence":"additional","affiliation":[{"name":"Otolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Neff","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology-Head and Neck Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota;\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Tombers","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology-Head and Neck Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina L.","family":"Castner","sequence":"additional","affiliation":[{"name":"Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota;\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica K.","family":"Finnkirk","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erling","family":"Myrseth","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paal-Henning","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Clinical Medicine, University of Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Lund-Johansen","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Clinical Medicine, University of Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology-Head and Neck Surgery and"},{"name":"Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota;\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns14594","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/S0194-5998(95)70101-X","article-title":"Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma)","volume":"113","author":"American Academy of Otolaryngology-Head and Neck Surgery Foundation","year":"1995"},{"key":"b2-jns14594","series-title":"Clin Otolaryngol Allied Sci","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1046\/j.1365-2273.2000.00326.x","article-title":"Impairments, disabilities, and handicaps after acoustic neuroma surgery","volume":"25","author":"Bateman","year":"2000"},{"key":"b3-jns14594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"818","DOI":"10.3171\/jns.2003.99.5.0818","article-title":"Self-assessed quality of life after acoustic neuroma surgery","volume":"99","author":"Betchen","year":"2003"},{"key":"b4-jns14594","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1227\/NEU.0b013e31823f5afa","article-title":"Conservative management of vestibular schwannoma\u2014a prospective cohort study: treatment, symptoms, and quality of life","volume":"70","author":"Breivik","year":"2012"},{"issue":"Suppl 2","key":"b5-jns14594","series-title":"J Laryngol Otol","doi-asserted-by":"publisher","first-page":"S16","DOI":"10.1017\/S0022215113003216","article-title":"Factors associated with symptom-specific psychological and functional impact among acoustic neuroma patients","volume":"128","author":"Brooker","year":"2014"},{"key":"b6-jns14594","series-title":"Eur Arch Otorhinolaryngol","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1007\/s00405-010-1480-z","article-title":"Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management","volume":"268","author":"Charalampakis","year":"2011"},{"key":"b7-jns14594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"855","DOI":"10.3171\/2008.10.JNS081014","article-title":"Prospective comparison of quality of life before and after observation, radiation, or surgery for vestibular schwannomas","volume":"111","author":"Di Maio","year":"2009"},{"key":"b8-jns14594","series-title":"Headache","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1111\/j.1526-4610.2011.02068.x","article-title":"Postoperative headache following acoustic neuroma resection: occipital nerve injuries are associated with a treatable occipital neuralgia","volume":"52","author":"Ducic","year":"2012"},{"key":"b9-jns14594","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1016\/j.jocn.2011.05.009","article-title":"Systematic review of quality of life in the management of vestibular schwannoma","volume":"18","author":"Gauden","year":"2011"},{"key":"b10-jns14594","series-title":"Clin Otolaryngol","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1111\/j.1365-2273.2007.01427.x","article-title":"Translabyrinthine surgery for disabling vertigo in vestibular schwannoma patients","volume":"32","author":"Godefroy","year":"2007"},{"key":"b11-jns14594","series-title":"Otol Neurotol","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1097\/MAO.0b013e3181b4e3c9","article-title":"Conservative treatment of vestibular schwannoma: a follow-up study on clinical and quality-of-life outcome","volume":"30","author":"Godefroy","year":"2009"},{"key":"b12-jns14594","series-title":"ORL J Otorhinolaryngol Relat Spec","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1159\/000285182","article-title":"Quality of life in sporadic vestibular schwannoma: a review","volume":"72","author":"Gouveris","year":"2010"},{"key":"b13-jns14594","series-title":"Otolaryngol Clin North Am","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/j.otc.2011.12.012","article-title":"Management of surgical complications and failures in acoustic neuroma surgery","volume":"45","author":"Heman-Ackah","year":"2012"},{"key":"b14-jns14594","series-title":"Acta Otolaryngol","first-page":"42","article-title":"Psychological condition in patients with an acoustic tumor","volume":"133","author":"Hio","year":"2013"},{"key":"b15-jns14594","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1177\/019459988509300202","article-title":"Facial nerve grading system","volume":"93","author":"House","year":"1985"},{"key":"b16-jns14594","series-title":"Am J Gastroenterol","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1038\/ajg.2009.136","article-title":"Minimum clinically important difference for the Nepean Dyspepsia Index, a validated quality of life scale for functional dyspepsia","volume":"104","author":"Jones","year":"2009"},{"key":"b17-jns14594","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.1002\/1529-0131(200007)43:7<1478::AID-ANR10>3.0.CO;2-M","article-title":"Determining minimally important changes in generic and disease-specific health-related quality of life questionnaires in clinical trials of rheumatoid arthritis","volume":"43","author":"Kosinski","year":"2000"},{"key":"b18-jns14594","series-title":"Otol Neurotol","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1097\/MAO.0b013e3181e8c7cb","article-title":"Audiovestibular factors influencing quality of life in patients with conservatively managed sporadic vestibular schwannoma","volume":"31","author":"Lloyd","year":"2010"},{"key":"b19-jns14594","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/j.clineuro.2011.05.006","article-title":"Depression in relation to anxiety, obsessionality and phobia among neurosurgical patients with a primary brain tumor: a 1-year follow-up study","volume":"113","author":"Mainio","year":"2011"},{"key":"b20-jns14594","series-title":"Otol Neurotol","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1097\/MAO.0b013e31826dbd02","article-title":"Microsurgery versus stereotactic radiation for small vestibular schwannomas: a meta-analysis of patients with more than 5 years' follow-up","volume":"33","author":"Maniakas","year":"2012"},{"key":"b21-jns14594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"211","DOI":"10.3171\/jns.2001.94.2.0211","article-title":"Patient-assessed outcomes after excision of acoustic neuroma: postoperative symptoms and quality of life","volume":"94","author":"Martin","year":"2001"},{"key":"b22-jns14594","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1227\/01.NEU.0000340684.60443.55","article-title":"Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study","volume":"64","author":"Myrseth","year":"2009"},{"key":"b23-jns14594","series-title":"Neurosurgery","first-page":"67","article-title":"Untreated vestibular schwannomas: vertigo is a powerful predictor for health-related quality of life","volume":"59","author":"Myrseth","year":"2006"},{"key":"b24-jns14594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3171\/jns.2006.105.2.205","article-title":"Surgery for large vestibular schwannomas: how patients and surgeons perceive quality of life","volume":"105","author":"Nicoucar","year":"2006"},{"key":"b25-jns14594","series-title":"Neurosurgery","first-page":"77","article-title":"Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery","volume":"59","author":"Pollock","year":"2006"},{"key":"b26-jns14594","series-title":"Am J Otol","first-page":"427","article-title":"Acoustic neuroma surgery: outcome analysis of patient-perceived disability","volume":"18","author":"Rigby","year":"1997"},{"key":"b27-jns14594","series-title":"Ann Otol Rhinol Laryngol","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1177\/000348949610500601","article-title":"Measuring patient benefit from otorhinolaryngological surgery and therapy","volume":"105","author":"Robinson","year":"1996"},{"key":"b28-jns14594","series-title":"Cephalalgia","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1111\/j.1468-2982.2008.01790.x","article-title":"Headache syndromes after acoustic neuroma surgery and their implications for quality of life","volume":"29","author":"Schankin","year":"2009"},{"issue":"3","key":"b29-jns14594","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.3171\/2012.7.FOCUS12186","article-title":"Incidental vestibular schwannomas: a review of prevalence, growth rate, and management challenges","volume":"33","author":"Schmidt","year":"2012"},{"key":"b30-jns14594","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1002\/lary.20988","article-title":"Validation of a disease-specific quality-of-life instrument for acoustic neuroma: the Penn Acoustic Neuroma Quality-of-Life Scale","volume":"120","author":"Shaffer","year":"2010"},{"key":"b31-jns14594","series-title":"Otol Neurotol","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1097\/00129492-200606000-00018","article-title":"The natural history of vestibular schwannoma","volume":"27","author":"Stangerup","year":"2006"},{"key":"b32-jns14594","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1227\/NEU.0b013e3181f22660","article-title":"True incidence of vestibular schwannoma?","volume":"67","author":"Stangerup","year":"2010"},{"key":"b33-jns14594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"706","DOI":"10.3171\/2011.12.JNS111662","article-title":"Growth of untreated vestibular schwannoma: a prospective study","volume":"116","author":"Varughese","year":"2012"},{"key":"b34-jns14594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"400","DOI":"10.3171\/2010.3.JNS091802","article-title":"Decision analysis of treatment options for vestibular schwannoma","volume":"114","author":"Whitmore","year":"2011"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/122\/4\/article-p833.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/122\/4\/article-p833.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/122\/4\/article-p833.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T19:33:49Z","timestamp":1658691229000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/122\/4\/article-p833.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4]]},"references-count":34,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2014.11.jns14594","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4]]}}}