Tinnitus modulation by stapedectomy.

Abstract

To assess change in tinnitus severity after stapedectomy using the validated Tinnitus Functional Index (TFI) at 1 and 6 months in 2 cohorts of subjects with otosclerosis with different preoperative (TFIpre) distress levels. Prospective within-subjects repeated measures. Twenty-six subjects completed the study between January 2012 and April 2013. Demographic information, preoperative and postoperative audiometric data at 1 month, and TFI scores measured preoperatively within 1 month of stapedectomy and postoperatively at 1 and 6 months were captured and analyzed. Stapedectomy has its largest effect on tinnitus severity reduction within the first month of surgery. Cohort A (TFIpre > 15, n = 16) ΔTFI mean and median values were ∼20 for the intervals preoperatively to 1 month and preoperatively to 6 months (p values < 0.01) and dropped to ∼0 for the interval between 1 and 6 months postoperatively. Cohort B (TFIpre < 15, n = 10) ΔTFI mean and median values were ∼0 for all time intervals (all pairwise comparison p values > 0.05). Stapedectomy in patients with otosclerosis with more than a small problem with tinnitus (TFIpre > 15) will reduce severity by at least 1 clinical category in ∼85% of cases within 6 months of surgery. The majority of patients will experience stable tinnitus suppression within the first postoperative month. In patients with no tinnitus or less than a small problem with tinnitus (TFIpre < 15), stapedectomy carries a 10% risk of transient worsening of tinnitus at 1 month, which resolves by the sixth postoperative month.