Vestibular Complaints Impact on the Long-Term Quality of Life of Vestibular Schwannoma Patients

Fuentealba-Bassaletti, Constanza; Neve, Olaf M.; Esch, Babette F. van; Jansen, Jeroen C.; Koot, Radboud W.; Benthem, Peter Paul G. van; Hensen, Erik F.

doi:10.1097/mao.0000000000003773

Cited by 8 publications

(4 citation statements)

References 35 publications

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“…A strong relationship exists between the degree of dizziness and quality of life among patients with VS [45][46][47]. In our study, individual symptoms, such as the degree of dizziness or limitations in daily life, were elusive factors that can be important in future studies.…”

Section: Plos Onementioning

confidence: 74%

Fall-related injury among patients with vestibular schwannoma

Ölander,

Feychting,

Eriksson

et al. 2024

PLoS ONE

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Vestibular schwannoma can cause vestibular dysfunction; however, conflicting evidence exists regarding whether this affects the incidence of fall-related injuries in this patient population. This matched cross-sectional and cohort study assess the risk of fall-related injuries in patients with vestibular schwannoma. The study included patients with vestibular schwannoma treated at a tertiary referral hospital in Sweden between 1988 and 2014. Information on fall-related injuries was obtained from the National Patient Register, and matched population comparisons were randomly selected in a 1:25 ratio. Fall-related injuries occurring pre- (within 5 years before the diagnosis of vestibular schwannoma) and post-diagnostically (up to 3 years after diagnosis or intervention) were registered. The association between vestibular schwannoma and fall-related injuries was estimated using logistic regression and Cox proportional hazards analyses. We identified 1153 patients with vestibular schwannoma (569 [49%] women and 584 [51%] men), and 28815 population comparisons. Among the patients, 9% and 7% had pre- and post-diagnostic fall-related injuries, respectively, and among the comparisons, 8% and 6% had pre- and post-diagnostic fall-related injuries, respectively. There was no increased risk of pre- (OR 1.14; CI 0.92–1.41) or post-diagnostic 1 year (HR 1.16; CI 0.87–1.54) or 3 years (HR 1.11; CI 0.89–1.29) fall-related injury among the total patient cohort. In age-stratified analyses, we found an increased risk of pre-diagnostic fall-related injury among patients aged 50–69 years (OR 1.42; CI 1.10–1.88). Patients who underwent middle fossa surgery, regardless of age, had an increased risk of post-surgery fall-related injury within 3 years of follow-up (HR 2.68; CI 1.06–6.81). We conclude that patients with vestibular schwannoma have a low risk of enduring fall-related injuries. Middle-aged patients with dizziness and fall-related injuries should be considered for a vestibular clinical evaluation. Our results highlight the importance of rehabilitation in avoiding future fall-related injuries among patients undergoing middle fossa surgery.

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Section: Plos Onementioning

confidence: 74%

Fall-related injury among patients with vestibular schwannoma

Ölander,

Feychting,

Eriksson

et al. 2024

PLoS ONE

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“…It is hypothesized that this is the effect of central compensation. However, it has been reported that a proportion of VS patients suffer from vestibular symptoms in the long term, impacting on their long-term quality of life [ 2 ]. This may be because the vestibular compensation is insufficient, or because of other factors that affect dizziness and balance in this patient group.…”

Section: Introductionmentioning

confidence: 99%

The effect of intratympanic gentamicin as a prehabilitation strategy for objective and subjective vestibular function in patients undergoing microsurgery for a unilateral vestibular schwannoma

Fuentealba Bassaletti,

van Esch,

Jansen

et al. 2023

Eur Arch Otorhinolaryngol

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Objective To review the literature on intratympanic gentamicin treatment as prehabilitation for patients undergoing surgery for a unilateral vestibular schwannoma. Data sources A systematic literature search was conducted up to March 2023 in Pubmed, Embase, Cochrane, Web of Science, Academic Search Premier, Google Scholar and Emcare databases. Review methods Articles on the effect of intratympanic gentamicin followed by vestibular schwannoma surgery were reviewed. Data on objective vestibular function and subjective outcomes were compiled in tables for analysis. Relevance and methodological quality were assessed with the methodological index for non-randomized tool. Results A total of 281 articles were identified. After screening and exclusion of duplicates, 13 studies were reviewed for eligibility, of which 4 studies could be included in the review. The posturography test, the subjective visual horizontal test, and the optokinetic nystagmus test showed decreased vestibular function in the group of patients who received intratympanic gentamicin before microsurgery compared to the group of patients without gentamicin. Other objective tests did not show significant differences between patient groups. Subjective vestibular outcomes, as evaluated by questionnaires on quality of life and/or dizziness, did not seem to improve from intratympanic gentamicin pretreatment. Conclusion Vestibular schwannoma patients who received intratympanic gentamicin before surgical resection of the tumor performed better in the posturography test, subjective visual horizontal test, and the optokinetic nystagmus test afterwards. However, studies that also evaluated subjective outcomes such as dizziness, anxiety, depression, and balance self-confidence did not show a positive effect of intratympanic gentamicin on the vestibular complaints and symptoms.

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“…Dynamic posturography seems to correlate with the tumor size and canal paresis (2). Other factors may confuse the analysis or even hinder central vestibular compensation in patients with comorbidities such as diabetes, hypertension, smoking, alcohol consumption, and depression, which were not evaluated in the study by Fuentealba-Bassaletti et al (1).…”

mentioning

confidence: 99%

“…To the Editor : We read with interest the article recently published by Fuentealba-Bassaletti et al (1) titled “Vestibular complaints impact on the long-term quality of life of vestibular schwannoma patients” in the issue of Otology & Neurotology .…”

mentioning

confidence: 99%