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Abstract:

Ryzenman JM, Pensak ML, Tew JM Jr. Patient perception of comorbid conditions after acoustic neuroma management: survey results from the acoustic neuroma association. Laryngoscope. 2004;114:814-820.

Objectives/Hypothesis: Based on survey results of the Acoustic Neuroma Association, the patient ratings of the most difficult aspects of acoustic neuroma management were reported and a review of the literature was made regarding comorbid conditions associated with acoustic neuroma treatment and their impact on patient quality of life.

Study Design: Cohort study of 1940 patients who were members of the Acoustic Neuroma Association.

Methods: A detailed questionnaire was mailed to 2372 members of the Acoustic Neuroma Association to identify pre- and post-operative symptoms, complications, and long-term effects on physical and psychosocial function. For 1940 respondents (81.8%) who reported the “most difficult aspect of the AN [acoustic neuroma] experience,” the responses were analyzed by tumor size, surgical approach, and patient age and sex. Statistical analysis was performed using SPSS software.

Results: Respondents reported that the most difficult aspect of the acoustic neuroma experience was hearing loss (25.8%), followed by facial weakness (17.9%), eye problems (10.8%), and headache (10.5%). In order of frequency, men reported hearing loss, balance problems, perioperative surgical experience, and eye and facial weakness, and women reported hearing loss, facial weakness, eye problems, and headache. Facial weakness was a morbidity more often reported for men and women who had large tumors, who were young, or who had undergone the retrosigmoid approach. Balance dysfunction was significant in patients older than 75 years of age. In patients with small tumors, headaches and balance problems were frequently reported.

Conclusion: In the large cohort study of patients with acoustic neuroma, perceptions regarding the impact of treatment illustrated why it is incumbent on physicians to understand the sentiments of patients with acoustic neuroma when counseling them and recommending optimal management strategies.

Comment: My own limited experience in this area was as a neurosurgical intern when patients with dural patches over the acoustic neuroma site were required to undertake “daily” lumbar punctures in order to keep CSF pressure low in order to minimize dural leaks. A headache rate of only 10.5% seems remarkable progress, compared with my own personal experience of these patients some 15 years ago!—David S. Millson

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1526-4610.2004.04185_6.x

Publication date: October 1, 2004

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