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Change in Tinnitus after Treatment of Vestibular Schwannoma: Microsurgery vs. Gamma Knife Radiosurgery

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Author(s)
Soon Hyung ParkHee So OhJu Hyun JeonYong Ju LeeYong Ju MoonWon-Sang Lee
Keimyung Author(s)
Park, Soon Hyung
Department
Dept. of Otorhinolaryngology (이비인후과학)
Journal Title
Yonsei Medical Journal
Issued Date
2014
Volume
55
Issue
1
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.
Key Words: Vestibular schwannoma, tinnitus, microsurgery, gamma knife radiosurgery, cochlear nerve
Keimyung Author(s)(Kor)
박순형
Publisher
School of Medicine
Citation
Soon Hyung Park et al. (2014). Change in Tinnitus after Treatment of Vestibular Schwannoma: Microsurgery vs. Gamma Knife Radiosurgery. Yonsei Medical Journal, 55(1), 19–24. doi: 10.3349/ymj.2014.55.1.19
Type
Article
ISSN
0513-5796
DOI
10.3349/ymj.2014.55.1.19
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/37247
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학)
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