Long-term quality of life after surgery for cerebellopontine angle epidermoid cysts: a cross-sectional study

Cerebellopontine angle epidermoid cysts (CPA EC) are rare, benign tumors, which envelop neurovascular structures during their slow growth. Cranial nerve deficits are common in pre- and postoperative phases, and repeated surgery is often needed due to recurrences. What is the effect of CPA EC and its surgery on HRQoL? We conducted a cross-sectional study of consecutive patients surgically treated for CPA epidermoid cysts at a single center between 1975 and 2022. HRQoL was assessed using a self-administered survey consisting of the 15D instrument, alongside clinical and demographic data. Results were compared to an age-, sex-, and region-matched general population sample. Of eligible patients, 18/19 (95 %) responded. Median follow-up was 17 years (range 2–48 years). Most patients (78 %) reported persistent symptoms related to CPA EC surgery, notably hearing loss (50 %) and balance issues (50 %). The mean 15D score in the patient cohort was lower than in the general population (difference = 0.037; p = 0.28) representing a clinically important, though statistically non-significant, difference. Usual daily activities (difference=0.13; p=0.054) and hearing (difference=0.084; p=0.080) were most decreased. Functional independence remained high, with all patients ambulatory (mRS ≤ 3), and 50 % reported full function (mRS 0). Patients surgically treated for CPA epidermoid cysts have a long-term reduction in HRQoL compared to the general population, particularly in domains of day-to-day activities and hearing. While most patients report persistent symptoms, half consider having a normal functional status. • Patients operated for CPA ECs have a long-term reduction in HRQoL • Most affected domains of HRQoL are day-to-day activities and hearing • For comparison of HRQoL, a general population sample was used in the study • 78 % reported persistent symptoms related to CPA EC and surgery thereof • Half of patients consider having a normal functional status