작은 전정신경 종양의 수술 및 감마나이프 치료의 치료성적 및 삶의 질 평가

Clinical Result and Quality of Life after Microsurgery and Gamma Knife Radiosurgery in Small Size Vestibular Schwannoma

Objective : The aim of this study was to evaluate the treatment result and quality of life (QOL) in patients with intracanalicular to small-sized vestibular schwannoma (VS), who were managed with microsurgery or gamma knife radiosurgery (GKS). Methods : Medical records of 40 patients who were available on the telephone interview and were followed up more than 6 months after treatment for VS of Koss grade 2 or less from 1997 to 2007 were reviewed. Eighteen patients were treated with microsurgery via translabyrinthine approach and 22 patients were treated with GKS. We evaluated tumor control rate, complications and QOL. To evaluate the QOL, we used the Glasgow Benefit Inventory questionnaires with telephone interview. Result : The mean observation time was 26.85 months. Sixteen patients (88.89%) in microsurgery group did not develop recurrence of tumor. Twenty patients (90.91%) in GKS group were controlled with less than 140% volume increase. One patient in microsurgery group had facial nerve palsy (FNP) worse than House-Brackmann (H-B) Grade III at last follow-up, while no patient developed FNP worse than H-B grade III in GKS group. Although GKS group had higher score in GBI questionnaires, the difference was not significant in comparison with microsurgery group. Conclusion : In small VS, microsurgey and GKS showed similar tumor control and complication rate. Microsurgery group did not have worse QOL than GKS group.