Sex Differences in Vestibular Schwannoma

SIMPLE SUMMARY: Vestibular schwannomas can significantly affect the quality of life (QoL) of patients pre- and postoperatively. The impact of sex on symptom- and disease-specific aspects (i.e., facial function, hearing, tinnitus, vertigo) of quality of life has not been adequately investigated. The present study analyzed the sex-specific quality of life by surveying 260 vestibular schwannoma patients pre- and postoperatively. The results demonstrated that women were significantly more affected by dizziness, headaches, anxiety, and postoperative facial palsy. However, despite the greater physical impairment, general health improved equivalently or even more in female patients than in males postoperatively. These sex differences should be considered when counseling and managing patients. ABSTRACT: Vestibular schwannoma (VS) are equally common in men and woman. A number of epidemiological studies have reported on sex-specific aspects of incidence, tumor size, tinnitus and hearing loss. However, data on sex-specific, pre- and post-surgically quality of life (QoL) are rare. The objective of the present study was to determine sex-specific aspects on QoL in VS. Health-related QoL was analyzed in 260 patients (112 male/148 female) with unilateral sporadic VS using general (SF-36: general Short-Form Health Survey), disease-specific (PANQOL: Penn Acoustic Neuroma Quality-of-Life Scale, PANQOL) and symptom-specific (DHI: Dizziness Handicap Inventory; HHI: Hearing Handicap Inventory; THI: Tinnitus Handicap Inventory; FDI: Facial Disability Index) QoL questionnaires. Sex differences were evaluated pre- and postoperative by multi- and univariate analyses based on 200 preoperative and 88 postoperative questionnaires. Female patients were significantly more affected by dizziness, headaches, reduced energy and anxiety. Energy and balance changed similarly in both sexes after surgery. However, postoperative women tended to be more affected by facial palsy and headaches than men. Despite the greater physical impairment, general health improved equivalently or even more in female patients than in males. In conclusion, self-rated QoL in VS is significantly affected by sex and surgery. This should be taken into account when counseling VS patients regarding observation, radiotherapy, and surgery.