Larger tumor size and female gender suggest better tinnitus prognosis after surgical treatment in vestibular schwannoma patients with tinnitus

Abstract

Background: Tinnitus is a subjective auditory phantom phenomenon which can be highly distressing. About 63%–75% vestibular schwannoma (VS) had a symptom of tinnitus.

Objectives: To investigate the tinnitus maintenance mechanism from the view of tinnitus change after surgical treatment in VS patients.

Material and methods: We conducted a retrospective study of VS patients with tinnitus from August 2008 to February 2019 and did follow-ups on their changes of tinnitus after surgery.

Results: Among 298 VS cases, 201 of them had tinnitus symptom (67.4%). No statistical difference in the surgical approach was found between the tinnitus poor outcome and good outcome groups (p = .14), and statistical difference was found in gender (p = .04) and tumor size (p = .01) between the two groups. Binary logistic regression analysis revealed that gender (odds ratio [OR], 2.12; 95% CI, 1.10–4.08 [p = .03]) and tumor size (OR, 2.22; 95% CI, 1.16–4.24 [p = .02]) emerged as a significant and independent factor associated with the good outcome of tinnitus.

Conclusions and significance: The results of this study confirmed that the cochlear nucleus of the brainstem and above part of the brainstem may play an important role in the maintenance of tinnitus.

Chinese abstract

背景：耳鸣是一种主观的听觉幻觉现象, 可能会令人很苦脑。大约63%-75%的前庭神经鞘瘤（VS）患者有耳鸣症状。

目的：从VS患者术后耳鸣变化的角度探讨耳鸣治疗机制。

材料与方法：对2008年8月至2019年2月收治的VS耳鸣患者进行回顾性研究, 并对其术后耳鸣变化进行随访。

结果：298例VS患者中, 有耳鸣症状者201例（67.4%）。耳鸣预后不良组与预后良好组在手术方式上无统计学差异（p=.14）, 而两组在性别（p=0.04）与肿瘤大小（p=0.01）上有统计学差异。二元逻辑回归分析显示, 性别（比值比[OR], 2.12；95%CI, 1.10-4.08 [p=0.03]）和肿瘤大小（OR, 2.22；95%CI, 1.16-4.24 [p=0.02]）是与耳鸣良好预后相关的一个显著且独立的因素。

结论及意义：本研究结果证实脑干及脑干以上的耳蜗核可能在耳鸣的治疗中起重要作用。

Keywords:

• Tinnitus
• vestibular schwannoma
• cochlear nucleus
• brainstem
• translabyrinthine
• retrosigmoid sinus

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China under Grant [81820108009]; Beijing Municipal Science and Technology Commission under Grant [Z161100000116038]; and Beijing Municipal Health Commission under Grant [2016-1-5014].