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Change in tinnitus after treatment of vestibular schwannoma: microsurgery vs. gamma knife radiosurgery.
Yonsei Med J. 2014 Jan; 55(1):19-24.YM

Abstract

PURPOSE

Tinnitus is a very common symptom of vestibular schwannoma, present in 45 to 80% of patients. We evaluated changes in tinnitus after translabyrinthine microsurgery (TLM) or gamma knife radiosurgery (GKS).

MATERIALS AND METHODS

Among 78 patients with vestibular schwannoma who underwent TLM or GKS at Severance Hospital from 2009-2012, 46 patients with pre- or postoperative tinnitus who agreed to participate were enrolled. Pure tone audiometry, tinnitus handicap inventory (THI), visual analogue scale (VAS) scores for loudness, awareness, and annoyance were measured before and after treatment. Changes of THI and VAS were analysed and compared according to treatment modality, tumour volume, and preoperative residual hearing.

RESULTS

In the TLM group (n=27), vestibulocochlear nerves were definitely cut. There was a higher rate of tinnitus improvement in TLM group (52%) than GKS group (16%, p=0.016). The GKS group had a significantly higher rate of tinnitus worsening (74%) than TLM group (11%, p<0.001). Mean scores of THI and VAS scores significantly decreased in the TLM group in contrast to significant increases in the GKS group. Tumor volume and preoperative hearing did not affect the changes in THI or VAS.

CONCLUSION

GKS can save vestibulocochlear nerve continuity but may damage the cochlea, cochlear nerve and can cause worsening tinnitus. In cases where hearing preservation is not intended, microsurgery with vestibulocochlear neurectomy during tumor removal can sometimes relieve or prevent tinnitus.

Links

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Authors+Show Affiliations

Park SH
Department of Otorhinolaryngology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. ismoonmd@yuhs.ac.
Oh HS
No affiliation info available
Jeon JH
No affiliation info available
Lee YJ
No affiliation info available
Moon IS
No affiliation info available
Lee WS
No affiliation info available

MeSH

AdultFemaleHumansMaleMiddle AgedNeuroma, AcousticRadiosurgeryTinnitusTreatment Outcome

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24339282

Citation

Park, Soon Hyung, et al. "Change in Tinnitus After Treatment of Vestibular Schwannoma: Microsurgery Vs. Gamma Knife Radiosurgery." Yonsei Medical Journal, vol. 55, no. 1, 2014, pp. 19-24.
Park SH, Oh HS, Jeon JH, et al. Change in tinnitus after treatment of vestibular schwannoma: microsurgery vs. gamma knife radiosurgery. Yonsei Med J. 2014;55(1):19-24.
Park, S. H., Oh, H. S., Jeon, J. H., Lee, Y. J., Moon, I. S., & Lee, W. S. (2014). Change in tinnitus after treatment of vestibular schwannoma: microsurgery vs. gamma knife radiosurgery. Yonsei Medical Journal, 55(1), 19-24. https://doi.org/10.3349/ymj.2014.55.1.19
Park SH, et al. Change in Tinnitus After Treatment of Vestibular Schwannoma: Microsurgery Vs. Gamma Knife Radiosurgery. Yonsei Med J. 2014;55(1):19-24. PubMed PMID: 24339282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Change in tinnitus after treatment of vestibular schwannoma: microsurgery vs. gamma knife radiosurgery. AU - Park,Soon Hyung, AU - Oh,Hee So, AU - Jeon,Ju Hyun, AU - Lee,Yong Ju, AU - Moon,In Seok, AU - Lee,Won-Sang, PY - 2013/12/17/entrez PY - 2013/12/18/pubmed PY - 2014/6/28/medline KW - Vestibular schwannoma KW - cochlear nerve KW - gamma knife radiosurgery KW - microsurgery KW - tinnitus SP - 19 EP - 24 JF - Yonsei medical journal JO - Yonsei Med J VL - 55 IS - 1 N2 - PURPOSE: Tinnitus is a very common symptom of vestibular schwannoma, present in 45 to 80% of patients. We evaluated changes in tinnitus after translabyrinthine microsurgery (TLM) or gamma knife radiosurgery (GKS). MATERIALS AND METHODS: Among 78 patients with vestibular schwannoma who underwent TLM or GKS at Severance Hospital from 2009-2012, 46 patients with pre- or postoperative tinnitus who agreed to participate were enrolled. Pure tone audiometry, tinnitus handicap inventory (THI), visual analogue scale (VAS) scores for loudness, awareness, and annoyance were measured before and after treatment. Changes of THI and VAS were analysed and compared according to treatment modality, tumour volume, and preoperative residual hearing. RESULTS: In the TLM group (n=27), vestibulocochlear nerves were definitely cut. There was a higher rate of tinnitus improvement in TLM group (52%) than GKS group (16%, p=0.016). The GKS group had a significantly higher rate of tinnitus worsening (74%) than TLM group (11%, p<0.001). Mean scores of THI and VAS scores significantly decreased in the TLM group in contrast to significant increases in the GKS group. Tumor volume and preoperative hearing did not affect the changes in THI or VAS. CONCLUSION: GKS can save vestibulocochlear nerve continuity but may damage the cochlea, cochlear nerve and can cause worsening tinnitus. In cases where hearing preservation is not intended, microsurgery with vestibulocochlear neurectomy during tumor removal can sometimes relieve or prevent tinnitus. SN - 1976-2437 UR - https://www.unboundmedicine.com/medline/citation/24339282/Change_in_tinnitus_after_treatment_of_vestibular_schwannoma:_microsurgery_vs__gamma_knife_radiosurgery_ DB - PRIME DP - Unbound Medicine ER -