Analysis of quality of life and outcomes of vestibular schwannoma patients after resection and radiosurgery in an interdisciplinary treatment concept

Quality of life (QoL) is a crucial factor which has to be taken into account in the treatment of vestibular schwannomas. This study compared microsurgical and radiosurgical treatments, focusing on three. (1) evaluating post-treatment clinical outcomes, (2) assessing the effect on QoL and (3) analyzing complication rates, particularly in geriatric patients. In this retrospective study, 586 patients underwent either microsurgery or gamma knife radiosurgery between 1990 and 2013. Demographic and treatment data were collected, including quality of life (QoL) assessments using the Short Form 36 (SF-36) and evaluations of the Karnofsky Performance Status (KPS). Complication rates were also analyzed. The study included 194 microsurgery patients and 392 radiosurgery patients. Radiosurgery patients showed significantly better postoperative hearing and facial nerve function (p < 0.05). QoL scores were higher in the radiosurgery group for physical and emotional role functioning, while microsurgery patients (including aged 65 years and older) reported better scores for bodily pain and general health perceptions. Neurological complications were 41.9% in the microsurgery group, most of them being permanent (92.9%). Radiosurgery generally showed better preservation of hearing, facial nerve function, and quality of life compared to microsurgery, although both treatments appeared equally effective in older patients.