Patients' fears, expectations and satisfaction in relation to management of vestibular schwannoma:: A comparison of surgery and observation

Objective-To investigate patients' expectations, fears and satisfaction in relation to management of vestibular schwannoma in a comparison of observed and operated patients. Material and Methods-A total of 768 patients operated on for vestibular schwannoma and 247 patients diagnosed with and observed for the same condition answered a mailed questionnaire. Among several questions, the patients were asked to indicate the worst aspect of the management (surgery or observation) of their condition. Furthermore, the patients were asked if they regretted the choice of management and if the information provided by the medical staff was satisfactory. Results-Of the operated patients, 37% reported loss of hearing (anacusis) on the operated side to be the worst aspect of the operation and 38% of the observed patients found decreased hearing on the affected side to be the worst aspect. Of the operated patients, 653 (85%) did not regret having the operation, whereas 62 (8%) did. In the observed series, 206 patients (83%) did not regret the choice of observation, 12 (5%) did regret it and 29 (12%) did not answer the question. Of the operated patients, 448 (58%) were satisfied with the information given, whereas 289 (38%) were not satisfied. Of the observed patients, 175 (71%) were satisfied with the information given and 59 (24%) were not. The ratio of satisfied to dissatisfied patients did not change during the period 1976-2000. Conclusions-Overall, the worst aspect of vestibular schwannoma is the associated hearing loss, regardless of the treatment modality. A majority of both the operated and observed patients did not regret their choice of treatment modality and were satisfied with the information given by the medical staff, although there may be scope for further improvement in terms of the latter aspect.