■观察,放疗和手术是前庭神经鞘瘤(VS)的治疗选择。中心之间的决策不同,通常基于肿瘤特征(例如,大小)和预期的身体健康(PH)结果(即,听觉和面部功能)。然而,心理健康(MH)经常被低估。本研究的目的是确定VS治疗对PH和MH的影响。
■在一项前瞻性横断面研究中评估了PH和MH,该研究包括手术切除(SURG)前后的226例单侧散发性VS患者。生活质量(QoL)是通过自我评估问卷估计的:一般短期健康调查(SF-36),宾夕法尼亚大学听神经瘤生活质量量表(PANQOL),头晕障碍库存(DHI),听力障碍清单(HHI),耳鸣障碍清单(THI),和面部残疾指数(FDI)。QoL随时间的变化以及预测因素通过多变量协方差分析(MANCOVA)获得。
■总共,对173份术前问卷和80份术后问卷进行分析。与面部功能相关的PH显著恶化(FDI,PANQOL-面部)手术后。符合面部康复,然而,FDI在手术后的前五年内有所改善,与术前患者队列相比没有差异,最终。相比之下,MH(即,PANQOL-焦虑)和一般健康(即,PANQOL-GH)通过手术改善,并与切除程度相关。
■VS手术显著影响身心健康。虽然手术后PH可能会降低,当患者治愈时,MH可能增加。从业者在建议不完全VS治疗之前应考虑MH(例如,次全切除,观察或放射外科)。
UNASSIGNED: Observation, radiotherapy and surgery are treatment options in vestibular schwannomas (VS). Decision making differs between centers and is usually based on tumor characteristics (e.g., size) and the expected physical health (PH) outcome (i.e., hearing and facial function). However, mental health (MH) is often under-reported. The objective of the present study was to ascertain the impact of VS treatment on PH and MH.
UNASSIGNED: PH and MH were assessed in a prospective cross-sectional study including 226 patients with unilateral sporadic VS before and after surgical removal (SURG). Quality-of-life (QoL) was estimated by self-rating questionnaires: general Short-Form Health Survey (SF-36), Penn Acoustic Neuroma Quality-of-Life Scale (PANQOL), Dizziness Handicap Inventory (DHI), Hearing Handicap Inventory (HHI), Tinnitus Handicap Inventory (THI), and Facial Disability Index (FDI). QoL changes over time as well as predictive factors were accessed by multivariate analyses of covariance (MANCOVA).
UNASSIGNED: In total, 173 preoperative and 80 postoperative questionnaires were analyzed. There was a significant PH deterioration related to facial function (FDI, PANQOL-face) after surgery. In line with facial rehabilitation, however, FDI improved within the first five years after surgery and did not differ compared to the preoperative patient cohort, eventually. In contrast, MH (i.e., PANQOL-anxiety) and general health (i.e., PANQOL-GH) improved with surgery and correlated with the extent-of-resection.
UNASSIGNED: Physical and mental health is significantly influenced by VS surgery. While PH might decrease after surgery, MH potentially increases when patient is cured. Practitioners should take MH into account before advising an incompletely VS treatment (e.g., subtotal resection, observation or radiosurgery).