Abstract
BACKGROUND: Tinnitus is a common symptom in patients with vestibular schwannoma (VS). The impact of Gamma Knife radiosurgery (GKRS) on tinnitus and the health-related quality of life (HRQoL) of patients with VS remains unclear. This study evaluated the effect of GKRS on HRQoL affected by tinnitus. METHODS: From December 2020 to April 2022, spontaneous VS patients who had no prior history of treatment and underwent their first GKRS in this period were analyzed. Subjective distress from tinnitus was measured by the Tinnitus Handicap Inventory (THI) and their HRQoL by 36-Item Short Form Survey Version 2 (SF-36v2). Pre-GKRS THI and SF-36v2 were obtained, and after GKRS, consecutive THI and SF-36v2 were obtained during the follow-up period. Bowker's test, paired Student's t-test, and Spearman's correlation were used to analyze the changes in THI grade, SF-36v2 score, and the correlation between THI grade and SF-36v2 score. Factors affecting the THI grade change and SF-36v2 score were evaluated through univariate and multivariate models. RESULTS: Twenty of 34 patients showed serviceable hearing before GKRS. The median radiation dose of GKRS was 12.75 Gy (range, 12-21 Gy). Twenty-two of 33 patients demonstrated no change or worse THI grade after GKRS, but the change was not statistically significant (P =.34). However, with age, the odds ratio of THI improvement is 0.905 (95% CI 0.83-0.98, P=.02). Patients with serviceable hearing before GKRS displayed THI grade improvement (OR = 6.721; P = .03). Compared to those with pre-GKRS THI grade 1, grades 3 and 4 exhibited lower odds of THI improvement (OR =0.095; P=.0449). No significant change was noted in SF-36v2 scores after GKRS. A high THI grade was correlated with a low physical component score (P =.03) and mental component score (P=.0002) of SF-36v2. CONCLUSION: Although THI grade and SF-36v2 change before and after GKRS did not show statistical significance, several factors affected THI grade change. Moreover, the THI grade and SF-36v2 score had a significant negative correlation. Factors that may aggravate tinnitus and further impact HRQoL of VS patients should be taken into account when planning treatment and providing counseling to VS patients.