Semi-quantitative Assessment of Tinnitus Before and After Endovascular Treatment for Intracranial Dural Arteriovenous Fistula:Usefulness of the Tinnitus Handicap Inventory(THI)Score

Abstract

Intracranial dural arteriovenous fistulas(dAVFs)cause pulsatile tinnitus that can easily impair the individual's quality of life. In this study, we aimed to assess the usefulness of the semi-quantitative Tinnitus Handicap Inventory(THI)score before and after endovascular treatment in patients with intracranial dAVF by determining the relationship between the severity of pulsatile tinnitus, radiographic findings, and the effect of treatment. This study included a total of 14 sides in 13 patients who underwent endovascular therapy for pulsatile tinnitus due to intracranial dAVFs between March 2014 and September 2015. Using THI scores, the severity of pulsatile tinnitus was semi-quantitatively evaluated before and within 7 days after transarterial or transvenous embolization. Pre-treatment THI score was 37.9±24.0, ranging from 5 to 82. Transarterial or transvenous embolization significantly decreased THI score to 8.8±16.1(p<0.01). The average THI improvement(%)was 78.9±31.1% and significantly correlated with treatment results. Thus, THI improvement(%)was significantly lesser in patients with partial embolization than in those with near-total or complete embolization. These findings strongly suggest that THI score is quite useful in the semi-quantitative evaluation of the effects of endovascular therapy in patients with intracranial dAVF.