Living with a Vestibular Schwannoma: Bridging the Gap Between Treatment and Quality of Life—A Review of 25 Years of Quality of Life Outcomes in Patients

BACKGROUND: Vestibular schwannoma (VS), a non-cancerous tumour of the vestibulocochlear nerve, poses significant challenges to patients’ quality of life (QoL), regardless of its typically slow growth and high treatment success rates. Although tumour control is excellent with microsurgery, stereotactic radiosurgery, or active surveillance, many patients report persistent symptoms affecting physical, psychological, and social well-being. OBJECTIVE: This review synthesises current scientific and medical literature published on QoL outcomes in VS patients, highlighting symptom burden, treatment impacts, and gaps in patient-centred care. METHODS: A narrative review was conducted following PRISMA guidelines. Studies were included if they assessed QoL in adult VS patients using validated tools or qualitative methods. Key themes were identified and analysed across management modalities. RESULTS: Physical symptoms such as hearing loss, facial weakness, dizziness, and fatigue significantly impact QoL. Psychological concerns—including anxiety, depression, and uncertainty—are underreported in the literature but prevalent amongst patients. The SF-36 and PANQOL were the most commonly used QoL tools, though they varied in sensitivity. Few studies incorporated long-term follow-up or patient perspectives. CONCLUSION: QoL assessment should be integrated into routine VS care. Future research must prioritise longitudinal data, emotional support needs, and patient involvement in decision-making to ensure holistic, equitable treatment strategies.