Abstract
Objective
To assess the impact of differential hearing loss on QOL in sporadic unilateral vestibular
schwannoma.
Patients and Methods
Cross-sectional observational multicenter study including 422 patients with vestibular
schwannoma and formal audiometry within 1 year of survey administration, analyzed
using multivariable regression.
Results
Among 422 patients included, the median age was 57 (range, 18-81) years; 223 (53%)
were women. Among 390 patients with complete audiometric data, American Academy of
Otolaryngology-Head and Neck Surgery class was A in 134 (34%), B in 69 (18%), C in
26 (7%), and D in 161 (41%). A total of 335 of 390 (86%) reported subjective ipsilateral
hearing loss (median severity, 6/10 [1 = normal, 10 = deaf]), 166 (43%) reported ipsilateral
inability to use the telephone, 155 (37%) reported that hearing loss had affected
personal relationships, and 213 (51%) reported difficulty with conversations. After
adjusting for age and sex, the odds ratio (OR) for hearing loss adversely affecting
relationships was 4.4 for class B hearing vs class A (95% CI, 2.1-9.4; P<.0001). The OR for difficulty with conversations was 2.7 for class B vs class A (95%
CI, 1.4-5.3; P=.003). The OR for lost ipsilateral telephone use was 6.3 for class B vs class A (95%
CI, 3.2-13.0; P<.0001). Differences between class B and class C were not significant. WRS outperformed
PTA as a predictor of hearing-related QOL. The optimal threshold for predicting a
significant adverse impact on QOL was WRS less than 72% to 76%.
Conclusion
Hearing loss adversely affects QOL after only modest audiometric disability. The WRS
alone appears to be a much more reliable predictor of hearing-related QOL than PTA
or American Academy of Otolaryngology-Head and Neck Surgery class.
Abbreviations and Acronyms:
AAO-HNS (American Academy of Otolaryngology-Head and Neck Surgery), AUC (area under the curve), HC (hearing class), OR (odds ratio), PANQOL (Penn Acoustic Neuroma Quality-of-Life Scale), PTA (pure tone average), QOL (quality of life), ROC (receiver operating characteristic), VS (vestibular schwannoma), WRS (word recognition score)To read this article in full you will need to make a payment
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Article Info
Footnotes
Potential Competing Interests: The authors declare no competing interests.
Identification
Copyright
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