Identification of factors associated with tinnitus outcomes following the microsurgical treatment of vestibular schwannoma patients

Abstract

Background

Tinnitus is common in vestibular schwannoma patients, but the postoperative tinnitus status of these patients and related factors remain unclear.

Aims

To identify preoperative and operative factors associated with postoperative tinnitus status.

Materials and methods

Postoperative outcomes were retrospectively assessed in 237 vestibular schwannomas (VS) patients with preoperative tinnitus and 90 VS patients without tinnitus.

Results

When evaluating patients with preoperative tinnitus, there were significant differences in rates of improvement, no change, and worsening of tinnitus for the translabyrinthine (TL) and retrosigmoid (RS) approaches. Of patients without preoperative tinnitus, there was a significant difference in rates of not developing tinnitus and new-onset tinnitus. Similar results were observed with respect to preoperative hearing. Least-squares analyses revealed that surgical approach and preoperative hearing were independent predictors of postoperative tinnitus. Preoperative pure tone averages for TL group patients that did not develop postoperative tinnitus were 85.8 dB, whereas in patients that developed new-onset tinnitus they were significantly lower (54.9 dB).

Conclusions and significance

Tinnitus prognosis in VS patients is better following TL microsurgery relative to RS microsurgery and is also better in patients with worse preoperative hearing. New-onset tinnitus was more likely to occur in patients with better preoperative hearing that underwent tumor removal via a TL approach.

Chinese abstract

背景：耳鸣常见于前庭神经鞘瘤患者, 但这些患者的术后耳鸣状况及其相关因素尚不清楚。

目的：确定与术后耳鸣状态相关的术前和手术因素。

材料和方法：回顾性评估237例有术前耳鸣的前庭神经鞘瘤（VS）患者和90例无耳鸣的VS患者的术后结果。

结果：在评估术前耳鸣患者过程中, 发现在经迷路（TL）和乙状窦后（RS）法之间在耳鸣改善率、无变化和耳鸣恶化方面存在很大的差异。在没有术前耳鸣的患者中, 在没有患上耳鸣的比率和新发作耳鸣的比率之间存在很大差异。对于术前听力也观察到类似结果。最小二乘法分析显示手术方法和术前听力是术后耳鸣的独立预测因子。未发生耳鸣的 TL组患者术前纯音平均值为85.8 dB, 而新发耳鸣的患者具有低得多的术前纯音平均值（54.9 dB）。

结论和意义：TL显微手术后VS患者的耳鸣预后相较于RS显微手术更好, 术前听力较差的患者也是如此。术前听力较好且通过TL法切除肿瘤的患者更容易发生新发耳鸣。

Keywords:

• Tinnitus
• translabyrinthine
• retrosigmoid
• PTAs

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by grants from the Beijing Nova Program [Z201100006820133]; the National Key Research and Development Project [2019YFC0121302]; the National Key Research and Development Project [2019YFC0840707].