Translabyrinthine surgery for disabling vertigo in vestibular schwannoma patients

Objective: To determine the impact of translabyrinthine surgery on the quality of life in vestibular schwannoma patients with rotatory vertigo. Study design: Prospective study in 18 vestibular schwannoma patients. Setting: The study was conducted in a multispecialty tertiary care clinic. Participants: All 18 patients had a unilateral intracanalicular vestibular schwannoma, without serviceable hearing in the affected ear and severely handicapped by attacks of rotatory vertigo and constant dizziness. Despite an initial conservative treatment, extensive vestibular rehabilitation exercises, translabyrinthine surgery was performed because of the disabling character of the vertigo, which considerably continued to affect the patients' quality of life. Main outcome measures: Preoperative and postoperative quality of life using the Short Form 36 Health Survey (Short Form-36) scores and Dizziness Handicap Inventory (DHI) scores. Results: A total of 17 patients (94%) completed the questionnaire preoperatively and 3 and 12 months postoperatively. All Short Form-36 scales of the studied patients scored significantly lower when compared with the healthy Dutch control sample (P < 0.05). There was a significant improvement of DHI total scores and Short Form-36 scales on physical and social functioning, role-physical functioning, role-emotional functioning, mental health and general health at 12 months after surgery when compared with preoperative scores (P < 0.05). Conclusions: Vestibular schwannoma patients with disabling vertigo, experience significant reduced quality of life when compared with a healthy Dutch population. Translabyrinthine tumour removal significantly improved the patients' quality of life. Surgical treatment should be considered in patients with small- or medium-sized tumours and persisting disabling vertigo resulting in a poor quality of life.