Miriam Nuño1, Beatrice Ugiliweneza2, Maxwell Boakye2, Ashkan Monfared3. 1. Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Davis, California. 2. Department of Neurosurgery, University of Louisville, Louisville, Kentucky. 3. Division of Otolaryngology and Department of Neurosurgery, George Washington University, Washington, District of Columbia.
Abstract
OBJECTIVE: Characterize the morbidity associated with vestibular schwannoma (VS) as documented by treating providers. STUDY DESIGN: Retrospective analysis of the MarketScan database. SETTING: MarketScan database. SUBJECTS AND METHODS: A study of morbidity in VS patients who underwent treatment between 2002 and 2012 was conducted. A detailed account of morbidity at multiple time points before and after treatment was described. RESULTS: Of 3,355 patients treated for VS, 2,029 (60.5%) underwent surgery and 1,326 (39.5%) radiation. The average (SD) age of diagnosis was 52.5 (12.1) years. Patients were followed for a mean (SD) of 29.1 (24.2) months before and 39.2 (30.5) months after treatment. Hearing loss (65.4%), vertigo (28.0%), tinnitus (24.7%), and headache (15.2%) were the most documented symptoms at 6 months before treatment. At this juncture, higher rates of hearing loss (71.6 versus 58.6%, p < 0.0001), vertigo (32.3 versus 21.4%, p<0.0001), and tinnitus (26.9 versus 21.5%, p=0.0004) were reported for the surgery cohort. At 6 months posttreatment, surgery cohort were reported to have higher rates of hearing loss (OR 2.15, 95% CI: 1.82-2.52), vertigo (OR 1.56, 95% CI: 1.23-1.96), balance (OR 4.17, 95% CI: 3.03-5.56), facial weakness (OR 10.0, 95% CI: 6.67-14.29), headache (OR 1.56, 95% CI: 1.23-1.96), fatigue (OR 2.22, 95% CI: 1.19-4.17), and swallowing difficulties (OR 2.33, 95% CI: 1.43-3.70) compared with radiosurgery group. Surgery patients also experienced more treatment-related complications than the radiation (28.5 versus 2.6%, p<0.0001) cohort. CONCLUSIONS: Patients who eventually underwent surgery were reported by their providers to have higher morbidity before and after treatment.
OBJECTIVE: Characterize the morbidity associated with vestibular schwannoma (VS) as documented by treating providers. STUDY DESIGN: Retrospective analysis of the MarketScan database. SETTING: MarketScan database. SUBJECTS AND METHODS: A study of morbidity in VS patients who underwent treatment between 2002 and 2012 was conducted. A detailed account of morbidity at multiple time points before and after treatment was described. RESULTS: Of 3,355 patients treated for VS, 2,029 (60.5%) underwent surgery and 1,326 (39.5%) radiation. The average (SD) age of diagnosis was 52.5 (12.1) years. Patients were followed for a mean (SD) of 29.1 (24.2) months before and 39.2 (30.5) months after treatment. Hearing loss (65.4%), vertigo (28.0%), tinnitus (24.7%), and headache (15.2%) were the most documented symptoms at 6 months before treatment. At this juncture, higher rates of hearing loss (71.6 versus 58.6%, p < 0.0001), vertigo (32.3 versus 21.4%, p<0.0001), and tinnitus (26.9 versus 21.5%, p=0.0004) were reported for the surgery cohort. At 6 months posttreatment, surgery cohort were reported to have higher rates of hearing loss (OR 2.15, 95% CI: 1.82-2.52), vertigo (OR 1.56, 95% CI: 1.23-1.96), balance (OR 4.17, 95% CI: 3.03-5.56), facial weakness (OR 10.0, 95% CI: 6.67-14.29), headache (OR 1.56, 95% CI: 1.23-1.96), fatigue (OR 2.22, 95% CI: 1.19-4.17), and swallowing difficulties (OR 2.33, 95% CI: 1.43-3.70) compared with radiosurgery group. Surgery patients also experienced more treatment-related complications than the radiation (28.5 versus 2.6%, p<0.0001) cohort. CONCLUSIONS:Patients who eventually underwent surgery were reported by their providers to have higher morbidity before and after treatment.
Authors: Inpyeong Hwang; Seung Hong Choi; Jin Wook Kim; Eung Koo Yeon; Ji Ye Lee; Roh-Eul Yoo; Koung Mi Kang; Tae Jin Yun; Ji-Hoon Kim; Chul-Ho Sohn Journal: Eur Radiol Date: 2022-01-27 Impact factor: 5.315