UBLISHED reports of outcome after acoustic neuroma surgery tend to be very much from the surgeon’s perspective, concentrating on surgical access, com- plications, facial nerve preservation, and mortality rates. 4–6,14,17 Indeed, it has been stated that “removal of an acoustic neuroma not only produces a cure but results in normal QOL and life expectancy.” 16 The evidence for this statement is lacking. Although recently more attention has been paid to patients’ perspective in focusing on their functional ability, generic QOL assessments have not been widely applied. In two studies QOL has been assessed following acous- tic neuroma surgery by using specific QOL measures. 10,22 In the study by Irving, et al., 10 the authors suggested that the postoperative QOL for patients with acoustic neuro- ma was excellent, but this result may have been biased because of the overall structure of the questionnaire. Van Leeuwen, et al., 22 discovered a considerably lower gener- al health status postoperatively compared with that of the general population and further found that general health status was closely correlated with QOL, suggesting that this is also worse compared with the norms. However, both studies incorporated scales designed for cancer pa- tients participating in clinical trials, with an individual- ly designed disease-specific component. Neither of these components had been used in other published studies or was validated. There were no normative data for either QOL measure. Nikolopoulos, et al., 17 used a questionnaire based on the Glasgow Benefit Inventory to assess changes in QOL in a nonconsecutive sample. The Glasgow Benefit Inventory relies on the patient’s retrospective comparison of health pre- and postoperatively to assess benefit, and includes one question to assess change in QOL. Whether it is bet- ter, the same, or worse depends greatly on the patient’s preoperative QOL. Hence, this can only be compared with QOLs reported in other studies in which change is as- sessed, not with an absolute QOL. Nor can the QOL be compared with that of the normal population. Moreover, the problems associated with retrospective assessment are well known. 3 There have been several other studies in which pa- tient-reported symptoms were used to assess outcome and QOL, 1,18,25 but none has involved the use of generic mea- sures. The present study was therefore designed to assess postoperative symptoms in a consecutive cohort of pa- tients after translabyrinthine excision of an acoustic neu- J. Neurosurg. / Volume 94 / February, 2001 J Neurosurg 94:211–216, 2001 Patient-assessed outcomes after excision of acoustic neuroma: postoperative symptoms and quality of life HELEN C. MARTIN, M.SC., JAGJIT SETHI, M.SC., DOROTHY LANG, F.R.C.S., GLEN NEIL-DWYER, F.R.C.S., MARK E. LUTMAN, PH.D., AND LUCY Y ARDLEY , PH.D. Audiology Department, Royal Hampshire County Hospital, Winchester; Clinical Audiology Department, Countess of Chester Hospital, Chester; Wessex Neurological Centre, Southampton General Hospital; and Hearing and Balance Centre, Institute of Sound and Vibration Research, and Department of Psychology, University of Southampton, United Kingdom Object. The aim of this study was to assess whether outcomes from excision of acoustic neuroma vary among patients and have a material impact on their quality of life (QOL). Methods. A questionnaire concerning postoperative symptoms and the Short Form 36 (SF-36) QOL instrument were mailed to 97 consecutive patients who had undergone acoustic neuroma surgery via the translabyrinthine ap- proach. The survey response rate was 78% and the symptomatology was consistent with other reports, supporting the representativeness of the sample. The respondents’ QOL was rated significantly below published norms and their work capacity was reportedly re- duced. Specifically, the following SF-36 dimensions were reduced: physical functioning and role-physical, together with vitality, general health, and social functioning. Greater numbers of postoperative symptoms and larger tumors were associated with a worse rating of physical functioning. More severe balance problems were associated with lower ratings of social functioning. The disparity between the patient’s self-estimate and self-measurement and the clinician’s assessment of the patient’s facial functioning raises doubts about the validity of subjective reports and assessment. Conclusions. The present study supports the use of generic QOL measures to assess outcome and to draw com- parisons between different populations. KEY WORDS • acoustic neuroma • quality of life • outcome P 211 Abbreviations used in this paper: QOL = quality of life; SF-36 = Short Form 36; UK = United Kingdom.