Results of leucotomy operations for tinnitus

Abstract

A leucotomy operation was performed on 20 patients (12 women and 8 men) for the relief of tinnitus. The clinical features of the patients are described. The age range was 46 to 70 at the time of operation. There was a preponderance of obsessional traits in the previous personality but this is not surprising, as this was one of the features which caused them to be selected for the operation. The period between onset of tinnitus and operation varied from 1–46 yr; the age of onset of the tinnitus varied between 15 and 68 with mean of 49.5 yr and S.D. 14.3; the interval between tinnitus and psychiatric illness was usually short, median less than 2 yr. Psychiatric illness came on between the ages of 36 and 67 with mean of 54.5 and S.D. 9.5. Operation was carried out at ages varying from 44–70 with mean of 58.3 yr and S.D. 7.3. Four patients had had frank psychiatric illness before the onset of tinnitus and most of the patients had received much psychiatric treatment before the operation. The main psychiatric diagnoses were reactive depression (10) and endogenous depression (4). In every case there was an organic basis for the tinnitus. Fourteen surviving patients were seen for assessment at an average interval of 6 years and 3 months after the operation, and the changes produced by the operation were formally assessed by the psychiatrist I(A.W.B.) and the P.S.W. (E.G.) on a social behaviour rating scale. Twelve were glad they had the operation, one regretted it and one could not say. The assessment of the relatives was similar to that of the patient, though in both assessments there were some discrepancies between objective and subjective results. All the patients except 2 found the head noises less distressing after the operation but objectively the noises were unchanged. Post-operative personality defects were usually transient or minimal. On the P.S.W.'s assessment gains were made in the yields of symptoms, employment, family relationships and community relationships. Most gains were made in the relief of symptoms but the differences were not marked between the different fields. The overall results of the operation were good with an improvement of 50 to 68% in the different fields and an average improvement of 54%.