Evaluation of the quality of life of patients with sporadic vestibular schwannoma
Keywords:vestibular schwannoma, quality of life, review
Today, the widespread use of neuroimaging diagnostic methods and increased awareness of primary care physicians has led to earlier diagnostics of intracranial tumors. Every year the number of cases of vestibular schwannomas (VS) diagnosed at the early stages is progressively increasing. The percentage of VS of small and medium sizes with unexpressed clinical signs serves as the basis for the discussion of the method of treatment choice. What method to choose as the primary link of therapy: dynamic observation (DO)? Radiosurgery (RS)? Microsurgery? Making the right choice is difficult not only for a patient, but also for an experienced doctor.
Literature data were reviewed in order to assess the quality of life (QOL) of patients with sporadic VS. The presented questionnaires, scales and their descriptions are used to assess QOL. The results of authoritative and highly cited studies on this subject are systematized.
According to most of the results of studies of QOL in patients with VS, small-sized tumors (< 15 мм) are subject to DO, especially under conditions of subjective satisfactory functional status of a patient. While selecting a method of treatment of VS, the active participation of a patient and his relatives is necessary. Any decision should be made in an attempt to maintain a balance between possible complications and the natural course of tumor development. When considering microsurgical removal or radiosurgical treatment of VS, it is obligatory to explain the possible risks of the emergence of new neurological deficit and increase of the existing one, with a decrease in QOL, as well as to explain of the prognostic factors that affect it. If RS is used, the possibility of long-term cessation of tumor growth, the long-term negative effects of irradiation on cranial nerve function and functional status of the patient, the risk of peritumorous edema and the possible malignancy of the tumor caused by RS should also be assessed.
In order to correctly assess the optimal tactics for treating VS, a good systematization of the results of the studies performed is necessary, followed by consideration of all the prognostic factors affecting QOL in each particular patient. The problem of the choice of treatment tactics, based on the prediction of QOL, depending on the chosen method of treatment, requires further study.
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