Quality of Life in Patients With Vestibular Schwannoma Treated With the Retrolabyrinthine Approach

OBJECTIVE: To investigate the factors affecting postoperative quality of life (QOL) and its longitudinal changes in patients undergoing vestibular schwannoma resection through the retrolabyrinthine approach (RLA). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Fifty-nine patients who underwent RLA for vestibular schwannoma between March 2016 and November 2022 and completed the Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire preoperatively and at least once at ≥6 months postoperatively. Patients were categorized into hearing preservation (n=37), hearing deterioration (n=19), and preoperative deafness (n=3) groups. INTERVENTION: Surgical resection of vestibular schwannoma through RLA with the intent of preserving hearing. MAIN OUTCOME MEASURES: Changes in PANQOL composite and subdomain scores over time. RESULTS: Total PANQOL scores remained stable postoperatively (mean scores: 69.7 preoperative, 72.3 at 6 mo, 76.4 at 1 y, and 75.1 at 2 y). Anxiety scores significantly improved after surgery. At 6 months postoperatively, hearing and balance scores were significantly lower in the hearing deterioration group compared with the hearing preservation group, though differences diminished by 1 and 2 years. Energy scores tended to be higher in the hearing preservation group. CONCLUSIONS: RLA contributes to maintaining or improving postoperative QOL. Hearing preservation supports not only auditory function but also emotional and social well-being.