Abstract
We designed a prospective study to evaluate changes in tinnitus after vestibular schwannoma (VS) surgery. Subjects included 41 patients who were diagnosed with a VS and underwent translabyrinthine microsurgery (TLM) between January 2015 and May 2016. All patients underwent related examinations and were asked to answer the Tinnitus Handicap Inventory (THI) scale and a visual analog scale (VAS) of tinnitus severity both pre- and postoperatively. Of the 41 patients, 31 (75.6%) suffered from tinnitus before surgery. Microsurgery was associated with an overall decrease in tinnitus (p < 0.001). There was a significant improvement in THI and VAS scores after surgery (p = 0.001 and p = 0.005, respectively). The decrease in THI scores in the low-frequency group was significantly larger than that of the mid- and high-frequency groups after surgery (p = 0.034 and p = 0.001, respectively). The loudness of tinnitus decreased significantly after surgery (p = 0.031). Tinnitus in patients with VS improved after TLM. Patients with mid-/high-frequency tinnitus and louder tinnitus preoperatively seemed to have a worse prognosis than those with low-frequency and quieter tinnitus.
Highlights
Tinnitus is the perception of sound in the absence of an external sound and usually results from a disorder of the somatosensory system or the auditory system[1]
Some patients still suffer from tinnitus even after tumor removal and vestibulocochlear nerve section, which supports the theory that tinnitus is likely a symptom of central origin[10,11,12,13,14]
We found a strong correlation between the postoperative Tinnitus Handicap Inventory (THI) score and postoperative visual analog scale (VAS) score (r = 0.947, p < 0.001) (Fig. 3)
Summary
Tinnitus is the perception of sound in the absence of an external sound and usually results from a disorder of the somatosensory system or the auditory system[1]. Several retrospective studies have been published focusing on changes in tinnitus after microsurgery; the results of these papers have varied Most of these papers showed that tinnitus improved after surgery regardless of whether translabyrinthine microsurgery (TLM), a retrosigmoid approach, or a middle cranial fossa approach was used[2,3,7]. These findings indicate that tinnitus originates in peripheral organs such as the cochlea or cochlear nerve[8,9]. With a VAS scale, patients self-grade the severity of tinnitus with possible scores ranging from 0 to 10 points; a score of 0 indicates no symptoms and a score of 10 indicates extremely loud tinnitus that seriously affects a patient’s daily life[19]
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