Analysis of Vestibular Schwannoma Treatment Experiences on Reddit

Objectives: Patients increasingly use online peer-support communities like Reddit to interpret symptoms, compare treatment options, and set recovery expectations, particularly for preference-sensitive conditions like vestibular schwannomas. This study evaluated patient sentiment and engagement related to vestibular schwannoma management within the r/AcousticNeuroma subreddit. Design: Retrospective cross-sectional study. Setting: r/AcousticNeuroma subreddit (January 2021 to October 2025). Participants: Posts and comments discussing vestibular schwannoma management were manually extracted and classified by treatment category: observation, surgery, radiation, or both. Eligible posts had net scores ≥ 15; comments required ≥ 10 words and discussed treatment. Main Outcome Measures: Sentiment analysis was performed using TextBlob and VADER. Continuous outcomes were summarized as medians (Q1, Q3) and compared using nonparametric tests, while categorical variables were compared using appropriate tests, with adjustment for multiple comparisons when applicable. Results: Of 232 entries analyzed (45 posts, 187 comments), 90.1% discussed surgical treatment. Sentiment was predominantly positive (TextBlob: 75.6% posts, 78.1% comments; VADER: 68.9% posts, 76.5% comments). Among surgical entries, VADER compound scores were significant higher post-treatment compared to pre-treatment (0.804 versus 0.571, p = 0.030). Sentiment expressed in posts was positively correlated with sentiment of associated comments. Common themes included facial nerve dysfunction, hearing loss, imbalance, and recovery uncertainty. Conclusion: Patient sentiment towards vestibular schwannoma management on Reddit is largely positive, with sentiment improving during post-treatment recovery among surgical patients. Recognizing patients incorporate online peer narratives into treatment expectations, physicians can proactively address common concerns to facilitate shared decision-making.