Validation of Outcome Measurements in Surgically Treated Vestibular Schwannomas

Introduction: Surgical resection of benign skull base tumors carries risk of postoperative morbidity. With decrease in morbidity and mortality, concerns and expectations for surgery have changed. In this scenario it is essential to assess risk of postoperative morbidity and incapacity. In the present study, we have validated different outcome tools with preoperative factors. Patients and Methods: A total of 167 patients from a retrospective and a prospective cohort who underwent microsurgical resection for vestibular schwannomas between 2001 and 2010 were surveyed. Preoperative variables such as age, gender, tumor size, and neurological symptoms were assayed against different outcome measures such as QOL work capacity/independency (actual work capacity, Karnovsky, independency), facial function (HB and SB), neurological score (patients and physicians score) in univariate and multivariate analysis. Results: All outcome measures except Eq. 5D showed a significant decrease postoperatively. Only HB grade differed significantly between the cohorts with a better score in the prospective cohort. Patient assessed neurological score correlated significantly to all other outcome measures. Conclusion: Standard QOL instruments may not be sensitive enough to measure outcome after surgery of benign skull base tumors, work capacity is useful in younger patients but patient assessed morbidity may be more useful in all patients.