scholarly journals Quality of life following surgery for large and giant vestibular schwannomas: a prospective study

2015 ◽  
Vol 122 (2) ◽  
pp. 303-311 ◽  
Author(s):  
Mazda K. Turel ◽  
Sumit Thakar ◽  
Vedantam Rajshekhar

OBJECT Prospective studies of quality of life (QOL) are infrequently performed in patients undergoing surgery for vestibular schwannoma (VS). The authors designed this to study to investigate health-related QOL (HR-QOL) in patients with large and giant VSs before and after surgery. METHODS Between January 2009 and December 2012, HR-QOL was measured prospectively before and after surgery, using the 36-Item Short Form Health Survey (SF-36), in 100 patients who underwent surgery for unilateral large or giant VS (tumor size ≥ 3 cm). The Glasgow Benefit Inventory (GBI) was also used to evaluate the effect of surgery. RESULTS A total of 100 patients were included in the study (65 men and 35 women). Their mean age (± SD) was 44.2 ± 11.5 years. The preoperative QOL was decreased in all SF-36 domains. A 1-year follow-up evaluation was conducted for all patients (mean 13.5 ± 5.3 months after surgery). The results showed an improvement in HR-QOL compared with preoperative status in all cases, with 63%–85% of patients showing a minimum clinically important difference (MCID) in various domains. A second follow-up evaluation was performed in 51 cases (mean time after surgery, 29.0 ± 8.3 months) and showed sustained improvement in SF-36 scores. In some domains there was further improvement beyond the first follow-up. On the GBI, 87% of patients reported improvement, 1% felt no change, and 12% of patients reported deterioration. CONCLUSIONS Patients harboring large or giant VSs score lower on all the QOL domains compared with the normative population. More than 60% showed a clinically significant improvement in HR-QOL 1 year after surgery, a result that was sustained at subsequent follow-up.

Neurosurgery ◽  
2011 ◽  
Vol 70 (5) ◽  
pp. 1072-1080 ◽  
Author(s):  
Cathrine Nansdal Breivik ◽  
Jobin K. Varughese ◽  
Tore Wentzel-Larsen ◽  
Flemming Vassbotn ◽  
Morten Lund-Johansen

Abstract BACKGROUND: One hundred ninety-three patients with sporadic unilateral vestibular schwannoma given conservative management were enrolled in a prospective study. OBJECTIVE: To evaluate the efficacy of conservative management and to determine the effect of an initial conservative management on the quality of life (QOL) and severity of audio vestibular symptoms. METHODS: The patients underwent magnetic resonance imaging scans, clinical examination, and QOL assessment by 2 validated questionnaires, the Short Form-36 (SF-36) and Glasgow Benefit Inventory (GBI). Using regression analysis of clustered data, we analyzed possible associations between tumor growth and symptoms and tested whether our earlier finding that vertigo is associated with reduced QOL could be verified. RESULTS: The median follow-up time was 43 months (range, 9–115 months; SD, 21.48 months). Results are based on 703 clinical controls and 642 (SF-36) and 638 (GBI) questionnaires. Seven patients were lost to follow-up. Approximately 40% of patients were in need of treatment during follow-up. We found a statistically significant association between tinnitus and vertigo and tumor growth. Vertigo was found to significantly reduce QOL. There was a significant drop in the Social Function subscales of both SF-36 and GBI, possibly attributable to progressive hearing loss. Otherwise, there was no overall trend toward any change in QOL during the observation period. In addition, QOL seemed to be little affected by treatment. CONCLUSION: There was a small but statistically significant improvement in vestibular complaints and no change in the occurrence of tinnitus. Except for hearing loss caused by surgery, treatment did not affect symptoms or QOL significantly. Growth was associated with the occurrence of tinnitus and balance problems.


2017 ◽  
Vol 37 (4) ◽  
pp. 320-327
Author(s):  
P.A. Oddon ◽  
M. Montava ◽  
F. Salburgo ◽  
M. Collin ◽  
C. Vercasson ◽  
...  

L’obiettivo di questo lavoro è stato di valutare la storia naturale di crescita degli schwannomi vestibolari (VS), la qualità di vita di quelli trattati in maniera conservativa e di validare una scala specifica per tale malattia in lingua francese, Penn Acoustic Neuroma Quality-of- Life (PANQOL). Sono stati studiati retrospettivamente 26 pazienti con VS trattato in maniera conservativa. Sono state raccolte le caratteristiche dei pazienti e i reperti radiologici, e sono state utilizzate due scale per validare valutare la qualità di vita: la Short Form-36 Health Survey (SF-36) e la PANQOL scale, tradotta in francese. I punteggi ottenuti sono stati comparati con gli studi precedenti. Il tempo medio di follow up è stato di 25 mesi (range 6-72). È stata osservato un accrescimento del tumore in 14 pazienti (53,8%), nessun accrescimento in 12 pazienti (46,2%), e non si è verificata nessuna riduzione. La crescita media del tumore è stata di 2,22 mm/anno, e non sono stati individuati fattori predittivi di crescita. I pazienti con vertigini e instabilità hanno riferito una più bassa qualità di vita, sia secondo la scala SF-36, sia secondo la scala PANQOL. Utilizzando la scala SF-36, i nostri risultati si sono rivelati paragonabili a quelli della letteratura. Utilizzando la scala PANQOL, i nostri punteggi non si sono rivelati statisticamente diversi da quelli derivanti da studi tedeschi e nordamericani, ad eccezione di quelli riguardanti l’udito (p=0,019). La qualità di vita diventa sempre più importante nella gestione dei VS. In linea con questi risultati, noi sosteniamo la strategia non conservativa associata ad una riabilitazione vestibolare per quei pazienti con vertigini ed instabilità. La scala PANQOL, disponibile in lingua francese, si è rivelata specifica per i VS.


2019 ◽  
Vol 38 (03) ◽  
pp. 219-226
Author(s):  
Alecio Cristino Evangelista Santos Barcelos ◽  
Sterphany Ohana Soares Azevedo Pinto ◽  
Thaise Ellen de Moura Agra Teixeira ◽  
Rayana Ellen Fernandes Nicolau

AbstractPedicle subtraction osteotomy (PSO) is a powerful tool for the management of sagittal misalignment. However, this procedure has a high rate of implant failure, particularly rod breakages. The four-rod technique diminishes this complication in the lumbar spine. The aim of the present study is to provide a case report regarding PSO and four-rod technique stabilization in the treatment of short-angle hyperkyphosis in the thoracolumbar (TL) junction. The authors describe the case of a patient with TL hyperkyphosis secondary to spinal tuberculosis treated with L1 PSO and fixation with a four-rod technique. There were no major surgical complications. The self-reported quality of life questionnaires (the Short-Form Health Survey 36 [SF-36] and the Oswestry disability index) and radiological parameters were assessed preoperatively, as well as 6, 12 and 24 months after surgery, and they showed considerable and sustained improvements in pain control and quality of life. No hardware failure was observed at the two-year follow-up.


2009 ◽  
Vol 35 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Maria Penha Uchoa Sales ◽  
Maria Irenilza Oliveira ◽  
Isabela Melo Mattos ◽  
Cyntia Maria Sampaio Viana ◽  
Eanes Delgado Barros Pereira

OBJECTIVE: To evaluate changes in health-related quality of life (HRQoL) after twelve months of smoking cessation. METHODS: This was a prospective study to evaluate the effectiveness of a smoking cessation program on the quality of life of 60 self-referred subjects, at a public hospital, during the period of August 2006 to December 2007. The program consisted of 2-h group sessions once a week during the first month and then every 15 days over six months, followed by monthly phone contacts for another six months. The treatment was based on behavior modification and the use of bupropion in combination with nicotinic replacement therapy. Abstinence was verified by exhaled CO measurements. Patient HRQoL was quantified using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire. Differences in quality of life scores between quitters and non-quitters at twelve months after the initial intervention were evaluated using analysis of covariance with baseline characteristics as covariates. RESULTS: Self-reported quality of life scores were significantly higher among the 40 quitters than among the 20 non-quitters. The following SF-36 domains were most affected: role-emotional (p = 0.008); general health (p = 0.006); vitality (p < 0.001); and mental health (p = 0.002). At twelve months after the smoking cessation intervention, the SF-36 mental component and physical component summary scores were higher among quitters than among non-quitters (p = 0.004 and p = 0.001, respectively). CONCLUSIONS: Our findings illustrate that smoking abstinence is related to better HRQoL, especially in aspects of mental health.


2014 ◽  
Vol 32 (14) ◽  
pp. 1427-1436 ◽  
Author(s):  
Elizabeth Maunsell ◽  
Paul E. Goss ◽  
Rowan T. Chlebowski ◽  
James N. Ingle ◽  
José E. Alés-Martínez ◽  
...  

Purpose Exemestane, a steroidal aromatase inhibitor, reduced invasive breast cancer incidence by 65% among 4,560 postmenopausal women randomly assigned to exemestane (25 mg per day) compared with placebo in the National Cancer Institute of Canada (NCIC) Clinical Trials Group MAP.3 (Mammary Prevention 3) trial, but effects on quality of life (QOL) were not fully described. Patients and Methods Menopause-specific and health-related QOL were assessed by using the four Menopause-Specific Quality of Life Questionnaire (MENQOL) domains and the eight Medical Outcomes Study Short Form Health Survey (SF-36) scales at baseline, 6 months, and yearly thereafter. MENQOL questionnaire completion was high (88% to 98%) in both groups at each follow-up visit. Change scores for each MENQOL and SF-36 scale, calculated at each assessment time relative to baseline, were compared by using the Wilcoxon rank-sum test. Clinically important worsened QOL was defined as a MENQOL change score increase of more than 0.5 (of 8) points and an SF-36 change score decrease of more than 5 (of 100) points from baseline. Results Exemestane had small negative effects on women's self-reported vasomotor symptoms, sexual symptoms, and pain, which occurred mainly in the first 6 months to 2 years after random assignment. However, these changes represented only a small excess number of women being given exemestane with clinically important worsening of QOL at one time or another; specifically, 8% more in the vasomotor domain and 4% more each in the sexual domain and for pain. No other between-group differences were observed. Overall, slightly more women in the exemestane arm (32%) than in the placebo arm (28%) discontinued assigned treatment. Conclusion Exemestane given for prevention has limited negative impact on menopause-specific and health-related QOL in healthy postmenopausal women at risk for breast cancer.


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii180-ii181
Author(s):  
Sung Choi ◽  
Emily Kowalski ◽  
Rahul Khairnar ◽  
Mark Mishra

Abstract The Quality-of-Life in Neurological Disorders (Neuro-QOL) instruments are a practical set of validated tools utilized to measure a core set of health-related quality-of-life parameters that are relevant to patients with neurological disorders. The tools can be completed in approximately 1-minute. The primary objective of this study was to evaluate the feasibility of utilizing the eight-question Neuro-QoL Cognitive Function- Short Form (NCF-SF) tool (v2.0) to assess cognitive outcomes in patients with primary and secondary brain tumors undergoing radiotherapy. Patients completed the NCF-SF at baseline and during follow-up visits. Raw scores were converted to a standardized T-score that has been normalized to have mean score of 50 and standard deviation (SD) of 10. Descriptive statistical analyses were performed to assess the prevalence of baseline cognitive impairment (defined as &gt; 1 SD below the normative mean), and to assess longitudinal changes in Neuro-QOL scores. A minimum clinically important difference (MCID) was defined as a change from baseline of &gt;7.5, based on previously published literature. Ninety-one patients completed NCF-SF at baseline and at least one follow-up visit. The mean baseline score for the study cohort was 49.9 (SD 9.2). Nineteen percent of patients (n=17/91) had impaired function at baseline. Baseline scores did not differ based on tumor type (p=0.79): Glioma/ependymoma 49.6 (n=35); brain metastases 49.1 (n=24); Meningioma/benign 50.7 (n=32). Following radiation, 15% and 22% of patients experienced a MCID decline at 1- (n=60) and 3- months (n=65), respectively. However, 17% and 20% of patients demonstrated a MCID improvement at 1- and 3-months, respectively. In conclusion, this represents the first study to utilize the NCF-SF to measure cognitive function in patients undergoing brain radiotherapy. Use of NCG-SF was feasible, and identified patients with meaningful changes in cognitive function over time. Future clinical trials may consider use of Neuro-QOL to assess patient-perceived cognitive function.


Author(s):  
Babak Mirzashahi ◽  
Pejman Mansouri ◽  
Arvin Najafi ◽  
Saeed Besharati ◽  
Mohammad Taha Kouchakinejad ◽  
...  

Background: This study aimed to determine the outcome of surgical treatments in patients with degenerative cervical myelopathy (DCM). During one-year follow-up period, we evaluated patient-reported functional and quality of life (QOL) measures.   Methods: In a retrospective single-center study, we collected data of patients with DCM who underwent cervical fusion surgeries in Imam Khomeini Hospital, Tehran, Iran, from 2011 to 2015. Patients underwent single or multi-level anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), or posterior laminectomy and fusion. We utilized patient-reported assessments including Short Form 36 (SF-36), Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Nurick grade. Follow-up was performed at 6 weeks, 3 months, 6 months, and 12 months post-operatively to assess the outcome of surgery.   Results: Ninety patients (56 men, 34 women) with a mean age of 54.1 (27-87) years were included. Comparison of pre- and post-operative scores showed significant improvement in SF-36 parameters, VAS, NDI, and Nurick grade (P < 0.001). Also, women’s VAS scores improved more than men's VAS scores during the follow-up period (P < 0.050). Age and type of surgery did not significantly affect the SF-36 parameters, VAS, NDI, and Nurick grade (P > 0.05).   Conclusions: Cervical surgeries in patients with different severity of DCM can improve different aspects of QOL during one-year after surgery


2017 ◽  
Vol 34 (4) ◽  
pp. 337-343 ◽  
Author(s):  
Gislene C. Erbs ◽  
Marco F. Mastroeni ◽  
Mauro S. L. Pinho ◽  
Álvaro Koenig ◽  
Geonice Sperotto ◽  
...  

Purpose: To assess how preexisting disabling comorbidities (DC) affect the recovery rate of quality of life (QOL) over time in sepsis survivors. Methods: A prospective study was conducted on sepsis survivors who answered the 36-Item Short Form Health Survey (SF-36) 7 days after discharge from the intensive care unit. Subsequent interviews were held at 3, 6, and 12 months. The results of the physical component score (PCS) and mental component score (MCS) of the SF-36 were evaluated. Patients were divided into 2 groups to compare patients with DC (DC group) and without DC (no-DC group). Quantile regression was used to model changes in PCS and MCS between different time points. Results: Seventy-nine sepsis survivors were enrolled. After controlling for baseline age and QOL, the QOL scores were lower among patients with DC than in no-DC patients. The QOL of DC group got worse when compared to no-DC group. Recovery rate of PCS and MCS was higher in the DC group than in the no-DC group (PCS: 20.51 vs 16.96, P < .01; MCS: 19.24 vs 9.66, P < .01). Their baseline QOL was recovered only by 6 months after the sepsis episode. Conclusion: Quality-of-life impairment and its recovery rhythm in patients with sepsis appear to be conditioned by coexisting DC.


Neurosurgery ◽  
2006 ◽  
Vol 59 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Erling Myrseth ◽  
Per Møller ◽  
Tore Wentzel-Larsen ◽  
Frederik Goplen ◽  
Morten Lund-Johansen

Abstract OBJECTIVE The aim of the present study was to characterise the relation between quality of life (QOL) and the four major complaints (hearing loss, tinnitus, vertigo and unsteadiness) caused by unilateral vestibular schwannoma (versus) in a cohort of well-characterised untreated patients. METHODS One hundred and ninety-nine consecutive patients (91 men, 108 women) with a mean age of 56.9 years were studied prospectively during the 4-year period 2001–2004. The average time span from symptom onset to the radiological diagnosis was 4.2 years. The patients were subject to a standardised examination including MRI, evaluation of hearing acuity, balance function by stabilometry, and a visual analogue scale (VAS) self-evaluation of tinnitus and vertigo. Furthermore, the patients responded to two questionnaires, Short-Form 36 (SF-36) and Glasgow Benefit Inventory (GBI)). A reference population was recruited from 80 adult persons who visited Haukeland University Hospital as non-patients or non-staff members. All data were recorded prospectively in a customised case report form. Statistical analysis was done with SPSS software. RESULTS The response rates of the Short-Form 36 and Glasgow Benefit Inventoryquestionnaires were 91.5 and 89.9%, respectively. According to the SF-36 questionnaire the patients scored significantly below that of expected norms with exception of physical function and mental health. Patients report negative benefit on the general and physical sections of the GBI questionnaire. Regression analysis showed that vertigo had a strong negative impact on QOL, whilst unilateral hearing loss and tinnitus had less impact on QOL. CONCLUSION Vertigo is the symptom causing the most pronounced negative effect on QOL in patients with versus The more frequent versus-symptoms unilateral hearing loss and tinnitus seem to be less important in the patients' perception of QOL evaluated by the questionnaires used in this study. If vertigo could be relieved by treatment, this symptom should be more in focus when discussing treatment options in small to medium sized versus


2017 ◽  
Vol 87 (3) ◽  
Author(s):  
Susanna Ricotti ◽  
Valentina Martinelli ◽  
Patrick Caspani ◽  
Serena Monteleone ◽  
Lucia Petrucci ◽  
...  

Lung transplantation (LT) increases the life expectancy of patients affected by end stage pulmonary disease; specifically, its ultimate aims are to improve survival and health related quality of life (HRQoL). The aim of the present longitudinal study was to determine the HRQoL trajectory and changes in functional capacity from time of entry in the waiting list for LT to 2 year after LT. The study included sixty-nine outpatients enrolled in a single medical center when they entered the waiting list for LT and who subsequently received it. They were then followed up over 2 years after LT. HRQoL was assessed by the physical and mental component summary (PCS and MCS) scores of the 36-item Short Form Health Survey (SF-36) and Saint George’s Respiratory Questionnaire (SGRQ). Psychological distress was evaluated with the General Health Questionnaire (GHQ), and functional capacity was investigated using the six-minute walk test (6MWT) and forced expiratory volume (FEV1). Patients showed low SF-36 PCS (30.5±7.8) and SGRQ total (61.8±17.5) scores at entry in the waiting list, but exhibited significant changes over time after LT (p<0.001). Furthermore, patients who showed an increase of at least 50% in SF36 PCS and SGRQ scores at 6 months survived longer. Both FEV1 and 6MWT distance as well as GHQ scores significantly changed over time, with improvements occurring in the first 6 months after LT but no major changes thereafter. Out of the 69 patients enrolled, 32 died over a median follow-up of 51 months. Although mortality tended to be slightly higher for patients with lower HRQoL at the baseline assessment, this difference was not statistically significant. HRQoL evaluations appear critical in the follow-up of LT candidates, in particularly SGRQ, because of its specificity in targeting respiratory symptoms and functional wellbeing.


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