The impact of tinnitus and vertigo on patient-perceived quality of life after cerebellopontine angle surgery.

Abstract

Quality of life (QOL) has come into focus after treatment for cerebellopontine angle (CPA) lesions. This study compared subjective (tinnitus, vertigo) and objective (hearing loss, facial palsy) results of CPA surgery with patient-perceived impairment of QOL. A retrospective analysis of a consecutive series of 48 patients operated on for either a vestibular schwannoma or a meningioma in the CPA was performed. Patient's subjective impairment of QOL by tinnitus, vertigo, hearing loss, and facial nerve palsy was assessed by a visual analog scale (VAS). Objective facial nerve and hearing function were determined using House-Brackmann and Gardner-Robertson classification systems, respectively. The return rate of questionnaires was 64.4%, with mean follow-up time of 417.2 (+/- 46.4) days. Mean preoperative tinnitus score was 2.5 (+/- 0.5) and increased to 4.6 (+/- 0.7) postoperatively (P < .01). The vertigo score increased from 2.0 (+/- 0.3) to 5.8 (+/- 0.6) (P < .001). Pre- and postoperative values for hearing loss were 3.4 (+/- 0.6) and 5.9 (+/- 0.7), respectively (P < .01), and for facial nerve palsy 0.7 (+/- 0.4) compared with 3.1 (+/- 0.6) postoperatively (P < .01). House-Brackmann grade 1 or 2 was determined in 87.1% of patients before and in 80.6% after surgery. Serviceable hearing (Gardner-Robertson classes I-III) was found in 75% before and in 64.3% after surgery. Preservation of facial nerve and hearing function are not the only important criteria defining QOL after CPA surgery. Tinnitus and vertigo may have a significant underestimated impact on the patient's postoperative course and QOL.