Patients' Subjective Evaluations of Quality of Life Related to Disease-specific Symptoms, Sense of Coherence, and Treatment in M??ni??re's Disease

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Abstract
Objective To evaluate the self-rated quality of life associated with vertigo, hearing loss, and tinnitus in Méniére's patients, and to identify potential relationships between these findings, treatment regimens, and sense of coherence in comparison to the classification of the American Academy of Otolaryngology–Head and Neck Surgery (AAO/HNS). Study Design Cross-sectional. Setting Tertiary referral hospital centers. Patients 112 patients with Méniére's disease, who had undergone endolymphatic sac surgery or intratympanic gentamicin injections, or were surgically untreated. Main Outcome Measure Questionnaires concerning quality of life aspects and symptom-specific instruments: the Vertigo Symptom Scale (VSS), the Hearing Disability Handicap scale (HDHS), the Tinnitus Severity Questionnaire (TSQ), the AAO/HNS criteria for reporting results of treatment of Méniére's disease, and the Sense of Coherence Scale. Results A majority of the patients reported their quality of life in general as very good or good. There was no difference in general quality of life, present hearing loss, or tinnitus between the three treatment groups, but the gentamicin-treated patients had less vertigo than did the other groups. Sense of coherence showed a strong correlation to reported quality of life in all measurements. Conclusions Even though the gentamicin-treated patients had less vertigo, no difference in overall quality of life was found between the surgically treated and untreated patients. The sense of coherence seems to be an important factor in the patient's experience of quality of life. Quality of life instruments can measure both specific symptoms and related aspects on quality of life and may give complementary information to the AAO/HNS classification in evaluating the treatment of patients with Méniére's disease.

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