Login to MyKarger

New to MyKarger? Click here to sign up.

Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Clinical Study

Editor's Choice - Free Access

Gamma Knife Radiosurgery for Vestibular Schwannomas and Quality of Life Evaluation

Berkowitz O.a-c · Han Y.-Y.b · Talbott E.O.b · Iyer A.K.a, d · Kano H.a · Kondziolka D.a, e · Brown M.A.c · Lunsford L.D.a

Author affiliations

aLeksell Center for Radiosurgery and Brain Mapping, University of Pittsburgh Medical Center, and bUniversity of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, cBoston University School of Medicine, Boston, MA, dStanford University School of Medicine, Stanford, CA, and eNew York University School of Medicine, New York, NY, USA

Corresponding Author

Oren Berkowitz, PhD, PA-C

Boston University School of Medicine

72 E. Concord St., Suite L801

Boston, MA 02118 (USA)

E-Mail orenberk@bu.edu

Related Articles for ""

Stereotact Funct Neurosurg 2017;95:166-173

Do you have an account?

Login Information

Contact Information

By signing up for MyKarger you will automatically participate in our year-End raffle.
If you Then Do Not wish To participate, please uncheck the following box.

Yes, I wish To participate In the year-End raffle And Get the chance To win some Of our most interesting books, And other attractive prizes.

I have read the Karger Terms and Conditions and agree.


Background: Further investigation is needed to look at the impact of vestibular schwannoma (VS) on the health-related quality of life (QOL) of participants who undergo Gamma Knife® radiosurgery (GKRS). Objectives: Investigators compared the QOL for VS participants to reported US population norms in order to evaluate disease burden and long-term QOL several years after GKRS. Methods: This cross-sectional study surveyed participants to assess hearing status, tinnitus, imbalance, vertigo, as well as the Short-Form 36-item Health Questionnaire (SF-36). The data were normalized, age adjusted, and functional status was correlated to determine clinically significant differences. Results: A total of 353 participants who underwent GKRS between 1997 and 2007 were included in this study with a median postoperative period of 5 years. SF-36 scores were very similar to population norms, and age-adjusted scores for participants followed the US population curve. Frequent vertigo and balance problems had the largest statistically and clinically significant effect on physical and mental component summary scores followed by nonuseful hearing in the tumor ear. Conclusions: Participants reported a good long-term QOL that was very similar to the QOL of US population norms. Of the common VS symptoms, vertigo had the greatest impact on QOL followed by imbalance and then hearing loss.

© 2017 S. Karger AG, Basel


  1. Gouveris HT, Mann WJ: Quality of life in sporadic vestibular schwannoma: a review. ORL 2010;72:69-74.
  2. Godefroy WP, Kaptein AA, Vogel JJ, van der Mey AGL: Conservative treatment of vestibular schwannoma: a follow-up study on clinical and quality-of-life outcome. Otol Neurotol 2009;30:968-974.
  3. Myrseth E, Pedersen P-H, Møller P, Lund-Johansen M: Treatment of vestibular schwannomas. Why, when and how? Acta Neurochir (Wien) 2007;149:647-660.
  4. Lobato-Polo J, Kondziolka D, Zorro O, Kano H, Flickinger JC, Lunsford LD: Gamma knife radiosurgery in younger patients with vestibular schwannomas. Neurosurgery 2009;65:294-301.
  5. Nakaya K, Niranjan A, Kondziolka D, et al: Gamma knife radiosurgery for benign tumors with symptoms from brainstem compression. Int J Radiat Oncol 2010;77:988-995.
  6. Régis J, Carron R, Park MC, et al: Wait-and-see strategy compared with proactive Gamma Knife surgery in patients with intracanalicular vestibular schwannomas. J Neurosurg 2010;113(suppl):105-111.
    External Resources
  7. Berkowitz O, Iyer AK, Kano H, Talbott EO, Lunsford LD: Epidemiology and environmental risk factors associated with vestibular schwannoma. World Neurosurg 2015;84:1674-1680.
  8. Pollock BE, Lunsford LD, Kondziolka D, et al: Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery. Neurosurgery 1995;36:215-224; discussion 224-229.
  9. Van Roijen L, Nijs HG, Avezaat CJ, et al: Costs and effects of microsurgery versus radiosurgery in treating acoustic neuroma. Acta Neurochir (Wien) 1997;139:942-948.
  10. Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-483.
    External Resources
  11. Berkowitz O, Kondziolka D, Bissonette D, Niranjan A, Kano H, Lunsford LD: The evolution of a clinical registry during 25 years of experience with Gamma Knife radiosurgery in Pittsburgh. Neurosurg Focus 2013;34:E4.
  12. Ware JE, Kosinski M, Dewey JE: How to Score Version 2 of the SF-36 Health Survey: Standards and Acute Forms. Lincoln, QualityMetric, 2001.
  13. Cohen J: Statistical Power Analysis for the Behavioral Sciences, ed 2. Hillsdale, Erlbaum Associates, 1988.
  14. Walters SJ: Sample size and power estimation for studies with health related quality of life outcomes: a comparison of four methods using the SF-36. Health Qual Life Outcomes 2004;2:26.
  15. Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D: Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics 1999;15:141-155.
  16. Carlson ML, Tveiten OV, Driscoll CL, et al: Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls. J Neurosurg 2015;122:833-842.
  17. Kim HJ, Roh KJ, Oh HS, Chang WS, Moon IS: Quality of life in patients with vestibular schwannomas according to management strategy. Otol Neurotol 2015;36:1725-1729.
  18. McLaughlin EJ, Bigelow DC, Lee JY, Ruckenstein MJ: Quality of life in acoustic neuroma patients. Otol Neurotol 2015;36:653-656.
  19. Myrseth E, Møller P, Pedersen P-H, Vassbotn FS, Wentzel-Larsen T, Lund-Johansen M: Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery 2005;56:927-935; discussion 927-935.
    External Resources
  20. Myrseth E, Møller P, Pedersen P-H, Lund-Johansen M: Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study. Neurosurgery 2009;64:654-663.
  21. Pollock BE, Driscoll CLW, Foote RL, et al: Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery. Neurosurgery 2006;59:77-85.
  22. Régis J, Pellet W, Delsanti C, et al: Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas. J Neurosurg 2002;97:1091-1100.
  23. Sandooram D, Grunfeld EA, McKinney C, Gleeson MJ: Quality of life following microsurgery, radiosurgery and conservative management for unilateral vestibular schwannoma. Clin Otolaryngol Allied Sci 2004;29:621-627.
  24. Timmer FCA, van Haren AEP, Mulder JJS, et al: Quality of life after gamma knife radiosurgery treatment in patients with a vestibular schwannoma: the patient's perspective. Eur Arch Otorhinolaryngol 2010;267:867-873.
  25. Wangerid T, Bartek J, Svensson M, Förander P: Long-term quality of life and tumour control following gamma knife radiosurgery for vestibular schwannoma. Acta Neurochir (Wien) 2014;156:389-396.
  26. Lloyd SKW, Kasbekar AV, Baguley DM, Moffat DA: Audiovestibular factors influencing quality of life in patients with conservatively managed sporadic vestibular schwannoma. Otol Neurotol 2010;31:968-976.
  27. Vogel JJ, Godefroy WP, van der Mey AGL, le Cessie S, Kaptein AA: Illness perceptions, coping, and quality of life in vestibular schwannoma patients at diagnosis: Otol Neurotol 2008;29:839-845.
  28. Henry JA, Dennis KC, Schechter MA: General review of tinnitus: prevalence, mechanisms, effects, and management. J Speech Lang Hear Res 2005;48:1204.
  29. Henry JA, Meikle MB: Psychoacoustic measures of tinnitus. J Am Acad Audiol 2000;11:138-155.
    External Resources
  30. Sullivan MD, Katon W, Dobie R, Sakai C, Russo J, Harrop-Griffiths J: Disabling tinnitus. Association with affective disorder. Gen Hosp Psychiatry 1988;10:285-291.
  31. Myrseth E, Møller P, Wentzel-Larsen T, Goplen F, Lund-Johansen M: Untreated vestibular schwannomas: vertigo is a powerful predictor for health-related quality of life: Neurosurgery 2006;59:67-76.
    External Resources
  32. Shaffer BT, Cohen MS, Bigelow DC, Ruckenstein MJ: Validation of a disease-specific quality-of-life instrument for acoustic neuroma: the Penn Acoustic Neuroma Quality-of-Life Scale. Laryngoscope 2010;120:1646-1654.
  33. Wiegand DA, Fickel V: Acoustic neuroma - the patient's perspective: subjective assessment of symptoms, diagnosis, therapy, and outcome in 541 patients. Laryngoscope 1989;99:179-187.

Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: October 25, 2016
Accepted: March 20, 2017
Published online: May 23, 2017
Issue release date: July 2017

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 6

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.