Abstract
Background
Patients suffering from vestibular schwannoma can choose between four modalities of management: (1) wait-and-scan, (2) tumour resection, (3) radiosurgery and (4) fractionated radiotherapy.
Method
This study is based on postal questionnaire survey of 739 vestibular schwannoma patients (survey response rate, 78%). It not only investigates the decision-making of patients, especially the medical consultation, but also further influences on the therapy decision and the patients’ evaluation of possible side-effects of the treatment.
Results
Only a minority of the patients was informed about radiosurgery and radiotherapy at all.
Conclusion
The praxis of patient counselling of acoustic neuroma patients in Germany is far from the ideal condition of medical consultation: The most important shortcoming is that it is unilateral: About 69% of the patients are informed about only one treatment option, generally surgery. Furthermore, information about side effects is usually insufficient. We recommend to advice all patients on all treatment options by an interdisciplinary team. The counselling should firstly be based on evidence-based medicine and secondly respond to the patients’ individual life situation and preferences.
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Acknowledgement
We thank Dieter Marten from the Vereinigung Akustikus Neurinom e. V. (VAN) for sending the questionnaires to the VAN members.
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Presentations at conferences
• Sabine Müller: Conference “Die Technisierung des Gehirns—Ethische Aspekte aktueller Neurotechnologien” (“The mechanisation of the brain—Ethical aspects of current neurotechnologies”), supported by the Bundesministerium für Bildung und Forschung (Federal Ministry for Education and Research, Germany), Freiburg (Germany), September 18th, 2007, title of the talk: “Ethische Dilemmata bei der Behandlung von Gehirntumoren am Beispiel der Therapie von Akustikusneurinomen” (“Ethical dilemmas in the therapy of brain tumours, especially of acoustic neuromas”)
• Ansel van Oosterhout and Sabine Müller: International Workshop on Neuroethics, June 7th, 2008, University Hospital Aachen, Germany, Title of the talk: “Acoustic neuromas: decision-making of patients”
• Sabine Müller: Regional Conference of the Vereinigung Akustikus Neurinom e.V. (Association Acoustic Neuroma), University Hospital Frankfurt a. M., Germany, Oct. 25th, 2008, Title of the talk: “Studie zu Therapientscheidungen von Akustikusneurinom-Patienten und zu deren Behandlungsfolgen” (“Study about therapy decisions of acoustic neuroma patients and about treatment sequelae”)
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Müller, S., Arnolds, J. & van Oosterhout, A. Decision-making of vestibular schwannoma patients. Acta Neurochir 152, 973–984 (2010). https://doi.org/10.1007/s00701-009-0590-0
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DOI: https://doi.org/10.1007/s00701-009-0590-0