The Long-Term Impact of Facial Palsy on the Quality of Life of Vestibular Schwannoma Patients.

Abstract

To compare long-term quality of life (QoL) of vestibular schwannoma (VS) patients with and without facial palsy. Longitudinal cohort study. Tertiary referral centre. To assess QoL, VS patients completed the Penn Acoustic Quality of Life (PANQOL) questionnaire twice: at baseline and 6 years later. The results of patients with facial palsy were compared to those without. The effect of facial nerve function, sex and tumor size on PANQOL scores was assessed. 484 patients completed the PANQOL. At baseline, 94% of patients had no or mild facial palsy and a mean PANQOL score of 71 out of 100 points (±18), while patients with moderate to severe palsy (6%) scored 61 points (±19). After 6 years, the PANQOL total scores remained relatively stable (70 and 57, respectively). In the multivariate analysis, the difference between patients without and with facial palsy was similar (PANQOL scores of 71 and 60, respectively). These differences do not exceed the predefined minimal clinically important difference (MCID) of 12.5 points. When focussing on questions related to facial function, differences are considerably larger (84 vs 41), exceeding the MCID. VS patients with facial palsy have lower mean total PANQOL scores than those without facial palsy, which remains on the long term. The difference did not exceed the MCID, which could suggest a limited impact of facial palsy on QoL, however, it may also point towards a limited sensitivity of the total PANQOL score for facial palsy-related quality of life.