Self-assessed quality of life after acoustic neuroma surgery

2003 ◽  
Vol 99 (5) ◽  
pp. 818-823 ◽  
Author(s):  
Simone A. Betchen ◽  
Jane Walsh ◽  
Kalmon D. Post
Keyword(s):  
Quality Of Life ◽  
Acoustic Neuroma ◽  
Hearing Level ◽  
Content Type ◽  
Sf 36 ◽  
Acoustic Neuroma Surgery ◽  
Persistent Headache ◽  
Facial Function ◽  
Fine Print

Object. The aim of this study was to determine if factors such as postoperative hearing, facial function, headaches, or other factors have an impact on self-assessed quality of life (QOL) after acoustic neuroma surgery. Methods. The SF-36 and seven additional questions on the impact of surgery on the QOL were sent to 135 consecutive patients who had undergone acoustic neuroma surgery. The Spearman rho correlations were calculated for each of the eight categories of the SF-36 (general health, physical functioning, physical role limitations, emotional role limitations, mental health, energy/vitality, pain, social functioning). The results were correlated with patients' sex, age, persistent headache, years since surgery, postoperative hearing level, and facial function. The response rate was 74.8%. The transformed scores of the eight categories of the SF-36 were lower than age-matched healthy controls in approximately half of the categories. The strongest trend toward lower scores with statistical significance in two categories was persistent headaches. Some categories demonstrated trends toward lower scores with females or age older than 55 years. Postoperative hearing and facial functioning, and time since surgery showed no statistically significant impact on QOL measured by the SF-36. Responses to the additional questions indicate that hearing, facial function, and headache influenced people's feelings about surgery and had an impact on their return to work. Conclusions. The QOL scores are not consistently lower than population normative values compared with different normative studies. The strongest correlation was between the presence of persistent headache and QOL. Other correlations were not consistent in all categories, and few were statistically significant. These trends in some categories do not explain the difference seen between patients after acoustic neuroma surgery in this study and normal populations in other studies.

Patient-assessed outcomes after excision of acoustic neuroma: postoperative symptoms and quality of life

2001 ◽  
Vol 94 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Helen C. Martin ◽  
Jagjit Sethi ◽  
Dorothy Lang ◽  
Glen Neil-Dwyer ◽  
Mark E. Lutman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Functioning ◽  
Acoustic Neuroma ◽  
Physical Functioning ◽  
Short Form ◽  
Content Type ◽  
Sf 36 ◽  
Postoperative Symptoms ◽  
Fine Print

Object. The aim of this study was to assess whether outcomes from excision of acoustic neuroma vary among patients and have a material impact on their quality of life (QOL). Methods. A questionnaire concerning postoperative symptoms and the Short Form 36 (SF-36) QOL instrument were mailed to 97 consecutive patients who had undergone acoustic neuroma surgery via the translabyrinthine approach. The survey response rate was 78% and the symptomatology was consistent with other reports, supporting the representativeness of the sample. The respondents' QOL was rated significantly below published norms and their work capacity was reportedly reduced. Specifically, the following SF-36 dimensions were reduced: physical functioning and role-physical, together with vitality, general health, and social functioning. Greater numbers of postoperative symptoms and larger tumors were associated with a worse rating of physical functioning. More severe balance problems were associated with lower ratings of social functioning. The disparity between the patient's self-estimate and self-measurement and the clinician's assessment of the patient's facial functioning raises doubts about the validity of subjective reports and assessment. Conclusions. The present study supports the use of generic QOL measures to assess outcome and to draw comparisons between different populations.

Outcome after complex neurosurgery: the caregiver's burden is forgotten

1999 ◽  
Vol 91 (3) ◽  
pp. 359-363 ◽  
Author(s):  
Dorothy A. Lang ◽  
Glenn Neil-Dwyer ◽  
John Garfield
Keyword(s):  
Quality Of Life ◽  
Major Change ◽  
Percutaneous Gastrostomy ◽  
Content Type ◽  
Petroclival Meningioma ◽  
Sf 36 ◽  
Permanent Neurological Deficit ◽  
The Impact ◽  
Fine Print

Object. The goals of this study were twofold: 1) to determine outcome, including quality of life, in patients who have undergone surgery for petroclival meningioma in which a standard skull base approach was used; and 2) to assess the impact of the patients' surgical treatment on their caregivers.Methods. Seventeen patients (13 women and four men ranging in age from 29 to 63 years) who underwent a transpetrosal approach for a petroclival meningioma during a 5-year period were prospectively included in this study. Pre- and postoperative data including adverse events were noted. The patients were assessed at 3, 6, and 12 months postoperatively, and annually thereafter, and they completed a postoperative SF-36 questionnaire. In addition, each patient's caregiver was interviewed to determine the effect of the patient's illness on the caregiver's life and responsibilities.Twenty-two operations were performed. A new permanent neurological deficit developed in five patients and in eight a temporary deficit or exacerbation of existing deficits occurred. Two patients underwent surgery to create a facial—hypoglossal nerve communication; five required a temporary percutaneous gastrostomy and/or tracheostomy; three required a shunt; and one underwent successful squint surgery. At 1 year postoperatively 13 patients had made a good or moderate recovery, three were severely disabled, and one had died—outcomes in keeping with other studies. By contrast, responses to the SF-36 questionnaire showed that, in all eight of its categories, between 43% and 75% of surviving patients were functioning below accepted norms. Fifty-six percent of caregivers experienced a major change in lifestyle and 38% experienced a major change with respect to their work.Conclusions. After transpetrosal excision of a petroclival meningioma, the quality of life for the patient is worse than that indicated in surgeons' reported results. The impact on the patient's caregiver is profound—a burden perhaps not fully appreciated by the surgeon.

Changes in functional outcome and quality of life in patients and caregivers after aneurysmal subarachnoid hemorrhage

2001 ◽  
Vol 95 (6) ◽  
pp. 957-963 ◽  
Author(s):  
Jeannette W. Hop ◽  
Gabriel J. E. Rinkel ◽  
Ale Algra ◽  
Jan van Gijn
Keyword(s):  
Quality Of Life ◽  
Subarachnoid Hemorrhage ◽  
Functional Outcome ◽  
Case Fatality ◽  
Time Interval ◽  
Consecutive Series ◽  
Content Type ◽  
Sf 36 ◽  
Fine Print

Object. Although the case-fatality rate after subarachnoid hemorrhage (SAH) does not change considerably after the first 4 weeks, functional outcome and the quality of life (QOL) may. To assess the extent of changes in functional outcome and QOL after SAH, the authors conducted a follow-up study at 18 months in patients and caregivers who had participated in a previous study of QOL 4 months after SAH. Methods. In a consecutive series of 98 patients admitted with SAH, 68 had survived until 4 months postbleed, at which time an initial outcome assessment had been performed in 64 of them. This series of 64 patients was contacted again at a median of 18 months after SAH. In all patients, functional outcome was assessed by means of the modified Rankin Scale (mRS). In 48 patients and 35 caregivers QOL was assessed using the SF-36, the Sickness Impact Profile (SIP), and a visual analog scale. The results were compared with the scores that had been obtained at 4 months after SAH. Thirty-two patients (50%) had improved at least one point on the mRS, in 23 patients functional outcome had remained unchanged, six patients had deteriorated one point on the mRS, and three had died. No major changes in the QOL of patients and caregivers could be found on the SIP, but on the SF-36 an improved QOL was detected in patients with better Rankin grades. On both instruments, the QOL at 18 months was still reduced compared with the reference population in all patients. Conclusions. Functional outcome improves significantly between 4 months and 18 months post-SAH; studies on functional outcome after SAH can be compared only if outcome is assessed at the same time interval. The improved functional outcome seems to be accompanied by an improved QOL.

Long-term health-related quality of life outcomes following Jefferson-type burst fractures of the atlas

2005 ◽  
Vol 2 (4) ◽  
pp. 411-417 ◽  
Author(s):  
Marcel F. Dvorak ◽  
Michael G. Johnson ◽  
Michael Boyd ◽  
Garth Johnson ◽  
Brian K. Kwon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Content Type ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Fine Print

Object. The primary goal of this study was to describe the long-term health-related quality of life (HRQOL) outcomes in patients who have suffered Jefferson-type fractures. These outcomes were compared with matched normative HRQOL data and with the patient's perceptions of their HRQOL prior to the injury. Variables that potentially influence these HRQOL outcomes were analyzed. No standardized outcome assessments have been published for patients who suffer these fractures; their outcomes have long thought to be excellent following treatment. Determining the optimal surrogate measure to represent preinjury HRQOL in trauma patients is difficult. Methods. A retrospective review, radiographic analysis, and cross-sectional outcome assessment were performed. The Short Form (SF)—36 and the American Academy of Orthopaedic Surgeons/North American Spine Society (AAOS/NASS) outcome instruments were filled out by patients at final follow-up examination (follow-up period 75 months, range 19–198 months) to represent their current status as well as their perceptions of preinjury status. In 34 patients, the SF-36 physical component score and the AAOS/NASS pain values were significantly lower than normative values. There was no significant difference between normative and preinjury values. Spence criteria greater than 7 mm and the presence of associated injuries predicted poorer outcome scores during the follow-up period. Conclusions. Long-term follow-up examination of patients with Jefferson fractures indicated that patients' status does not return to the level of their perceived preinjury health status or that of normative population controls. Those with other injuries and significant osseous displacement (≥ 7 mm total) may experience poorer long-term outcomes. Limitations of the study included a relatively low (60%) response rate and the difficulties of identifying an appropriate baseline outcome in a trauma population with which the follow-up outcomes can be compared.

scholarly journals Conservative treatment of vestibular schwannoma: growth and Penn Acoustic Neuroma Quality of Life scale in French language

2017 ◽  
Vol 37 (4) ◽  
pp. 320-327
Author(s):  
P.A. Oddon ◽  
M. Montava ◽  
F. Salburgo ◽  
M. Collin ◽  
C. Vercasson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Acoustic Neuroma ◽  
Short Form ◽  
Sono State ◽  
Sono Stati ◽  
Sf 36 ◽  
Quality Of Life Scale ◽  
Life Scale

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.

Health-related quality of life after subarachnoid hemorrhage: impacts of bleeding severity, computerized tomography findings, vasospasm, surgery, and neurological grade

2001 ◽  
Vol 94 (2) ◽  
pp. 241-251 ◽  
Author(s):  
Bernd O. Hütter ◽  
Ilonka Kreitschmann-Andermahr ◽  
Joachim M. Gilsbach
Keyword(s):  
Quality Of Life ◽  
Subarachnoid Hemorrhage ◽  
Daily Life ◽  
Health Related Quality ◽  
Content Type ◽  
Related Quality ◽  
Health Related ◽  
Mca Aneurysm ◽  
Fine Print

Object. Based on the results of earlier studies it is agreed that the significance of aneurysm location and surgery for neuropsychological impairments after subarachnoid hemorrhage (SAH) is secondary to the effects of the bleeding itself. Therefore, the present study was performed to evaluate whether bleeding, acute clinical course, and surgery have persistent effects on health-related quality of life (QOL) after SAH. Methods. A series of 116 patients was examined for 4 to 5 years (mean 52.2 months) after aneurysmal SAH by means of a QOL questionnaire. Eighty-six patients (74.1%) had undergone surgery early (≤ 72 hours post-SAH). There were 77 women (66.4%) and 39 men (33.6%) in the study group, and the mean age of the patients was 50.3 ± 13.3 years (range 30–69 years). Patients who had undergone surgery for a left-sided middle cerebral artery (MCA) aneurysm complained of significantly more impairments in social contact, communication, and cognition than those treated for a right-sided MCA aneurysm. No other effects of aneurysm location (including the anterior communicating artery) emerged. Multiple aneurysms, intraoperative aneurysm rupture, and partial resection of the gyrus rectus had no adverse effects on later daily life. Only temporary clipping was associated with increased complaints in some QOL areas. Disturbances of the circulation of cerebrospinal fluid and the presence of intraventricular hemorrhage led to more impairments in daily life. Specific effects of the anatomical pattern of the bleeding could be identified, but no adverse effects of vasospasm were found. Multivariate analyses revealed, in particular, that patient age and admission neurological status (Hunt and Hess grade) are substantial predictors of the psychosocial sequelae of SAH. Conclusions. In contrast to the mild effects of aneurysm surgery, patient's age, initial neurological state on admission, and the bleeding pattern substantially influence late QOL after SAH.

Quality-of-life assessment in patients who had been surgically treated for cerebellar pilocytic astrocytoma in childhood

2002 ◽  
Vol 96 (2) ◽  
pp. 229-234 ◽  
Author(s):  
Alfredo Pompili ◽  
Marco Caperle ◽  
Andrea Pace ◽  
Valerio Ramazzotti ◽  
Laura Raus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Life Experience ◽  
Well Being ◽  
Complete Recovery ◽  
Life Assessment ◽  
Control Group ◽  
Karnofsky Performance Scale ◽  
Content Type ◽  
Fine Print

Object. After radical surgery for childhood cerebellar astrocytomas, patients are considered to be cured. Long-term follow up demonstrates that these patients survive, with most of them leading a normal life. The study reported here was aimed at assessing the quality of life (QOL) of these adults, which is defined as a person's sense of well-being, as derived from his or her current experience of life as a whole. Methods. Twenty patients who had undergone surgery between 1970 and 1985 were enrolled in the study. In four patients ventriculoperitoneal shunts were in place; two of these patients had required more than six shunt revisions. At present, all patients have clear neuroimaging studies and their Karnofsky Performance Scale (KPS) scores are as follows: 70 in three, 80 in seven, 90 in six, and 100 in four. A QOL questionnaire was administered to the patients and to a control group consisting of 20 healthy volunteers of matching age and sex. The chi-square test was applied to compare patients and controls. Traditional questions on the level of education, work, whether the patients have their own families, and whether they possessed a driver's license were asked at the end of the questionnaire. In all the dimensions assessed except one (sex life), the difference between patients and control volunteers was significant, socializing and adolescence being the most striking ones. This was also true when the three patients with the lowest KPS scores and the worst QOL results were excluded. Conclusions. By traditional standards, these patients appear to fare quite well. Nevertheless, their self-reported life experience is unsatisfying when compared with the control group. The authors conclude that psychosocial factors are critical to complete recovery and the QOL of children who undergo successful operations for benign cerebellar astrocytoma.

Radiosurgery of vestibular schwannomas: summary of experience in 829 cases

2005 ◽  
Vol 102 ◽  
pp. 195-199 ◽  
Author(s):  
L. Dade Lunsford ◽  
Ajay Niranjan ◽  
John C. Flickinger ◽  
Ann Maitz ◽  
Douglas Kondziolka
Keyword(s):  
Quality Of Life ◽  
Gamma Knife ◽  
Cranial Nerve ◽  
Vestibular Schwannomas ◽  
Tumor Control ◽  
Content Type ◽  
Dose Planning ◽  
Fine Print

Object.Management options for vestibular schwannomas (VSs) have greatly expanded since the introduction of stereotactic radiosurgery. Optimal outcomes reflect long-term tumor control, preservation of cranial nerve function, and retention of quality of life. The authors review their 15-year experience.Methods.Between 1987 and 2002, some 829 patients with VSs underwent gamma knife surgery (GKS). Dose selection, imaging, and dose planning techniques evolved between 1987 and 1992 but thereafter remained stable for 10 years. The average tumor volume was 2.5 cm3. The median margin dose to the tumor was 13 Gy (range 10–20 Gy).No patient sustained significant perioperative morbidity. The average duration of hospital stay was less than 1 day. Unchanged hearing preservation was possible in 50 to 77% of patients (up to 90% in those with intracanalicular tumors). Facial neuropathy risks were reduced to less than 1%. Trigeminal symptoms were detected in less than 3% of patients whose tumors reached the level of the trigeminal nerve. Tumor control rates at 10 years were 97% (no additional treatment needed).Conclusions.Superior imaging, multiple isocenter volumetric conformal dose planning, and optimal precision and dose delivery contributed to the long-term success of GKS, including in those patients in whom initial microsurgery had failed. Gamma knife surgery provides a low risk, minimally invasive treatment option for patients with newly diagnosed or residual VS. Cranial nerve preservation and quality of life maintenance are possible in long-term follow up.

CyberKnife stereotactic radiosurgical treatment of spinal tumors for pain control and quality of life

2005 ◽  
Vol 2 (5) ◽  
pp. 540-549 ◽  
Author(s):  
Jeffrey W. Degen ◽  
Gregory J. Gagnon ◽  
Jean-Marc Voyadzis ◽  
Donald A. McRae ◽  
Michael Lunsden ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Spinal Tumors ◽  
Content Type ◽  
Cyberknife Radiosurgery ◽  
The Mean ◽  
Initial Score ◽  
Fine Print

Object. The authors conducted a study to assess safety, pain, and quality of life (QOL) outcomes following CyberKnife radiosurgical treatment of spinal tumors. Methods. Data obtained in all patients with spinal tumors who underwent CyberKnife radiosurgery at Georgetown University Hospital between March 2002 and March 2003 were analyzed. Patients underwent examination, visual analog scale (VAS) pain assessment, and completed the 12-item Short Form Health Survey (SF-12) before treatment and at 1, 3, 6, 8, 12, 18, and 24 months following treatment. Fifty-one patients with 72 lesions (58 metastatic and 14 primary) were treated. The mean follow-up period was 1 year. Pain was improved, with the mean VAS score decreasing significantly from 51.5 to 21.3 at 4 weeks (p < 0.001). This effect on pain was durable, with a mean score of 17.5 at 1 year, which was still significantly decreased (p = 0.002). Quality of life was maintained throughout the study period. After 18 months, physical well-being was 33 (initial score 32; p = 0.96) and mental well-being was 43.8 (initial score 44.2; p = 0.97). (The mean SF-12 score is 50 ± 10 [standard deviation].) Adverse effects included self-limited dysphagia (three cases), diarrhea (two cases), lethargy (three cases), paresthesias (one case), and wound dehiscence (one case). Conclusions. CyberKnife radiosurgery improves pain control and maintains QOL in patients treated for spinal tumors. Early adverse events are infrequent and minor. The authors await long-term follow-up data to determine late complications and tumor control rates.

Long-term benefits in quality of life provided by bilateral subthalamic stimulation in patients with Parkinson disease

2005 ◽  
Vol 103 (2) ◽  
pp. 252-255 ◽  
Author(s):  
Kelly E. Lyons ◽  
Rajesh Pahwa
Keyword(s):  
Quality Of Life ◽  
Parkinson Disease ◽  
Motor Function ◽  
Well Being ◽  
Strongly Correlated ◽  
Content Type ◽  
Fine Print

Object. The goals of this study were to evaluate long-term benefits in quality of life in patients with Parkinson disease (PD) after bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) and to evaluate the relationship between improvements in motor function and quality of life. Methods. Seventy-one patients who received bilateral STN stimulation implants and participated in follow-up review for at least 12 months were included in the study. Fifty-nine patients participated in a 12-month follow-up review and 43 patients in a follow-up review lasting at least 24 months. Patients' symptoms were assessed preoperatively by using the Unified PD Rating Scale (UPDRS) in the “medication-on” and “medication-off” conditions and quality of life was examined using the 39-item PD Questionnaire (PDQ-39). Patient evaluations were repeated postoperatively during periods of stimulation. The UPDRS activities of daily living (ADL) and motor scores as well as the PDQ-39 total, mobility, ADL, emotional well-being, stigma, and bodily discomfort scores were significantly improved at 12 months compared with baseline scores; the UPDRS ADL and motor scores as well as the PDQ-39 total, mobility, ADL, stigma, and bodily discomfort scores were significantly improved at the longest follow-up examination compared with baseline scores. There was a strong correlation between UPDRS motor and ADL scores and the PDQ-39 total, mobility, and ADL scores. Further analyses indicated that improvements in tremor were only correlated with PDQ-39 ADL subscale scores and rigidity was not correlated with any aspect of quality of life. Nevertheless, bradykinesia was strongly correlated with improvements in the PDQ-39 total, mobility, and ADL scores. Conclusions. Improvements in quality of life following bilateral DBS of the STN are maintained in the long term. These improvements are strongly correlated with improvements in motor function, primarily with regard to bradykinesia.

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