Does hearing preservation surgery for acoustic neuromas affect tinnitus?

Area of Science:

• Neurosurgery
• Otolaryngology
• Audiology

Background:

• Acoustic neuroma resection is a common treatment for this benign tumor.
• Tinnitus is a frequent symptom associated with acoustic neuromas and their surgical treatment.
• Understanding the impact of surgical approach on tinnitus is crucial for patient counseling.

Purpose of the Study:

• To compare the incidence and characteristics of tinnitus following acoustic neuroma resection based on surgical approach.
• To investigate the relationship between postoperative hearing preservation and tinnitus outcomes.
• To inform patients about potential tinnitus changes after surgery.

Main Methods:

• Analysis of questionnaires from 202 patients who underwent acoustic neuroma resection.
• Comparison of tinnitus incidence between hearing preservation (HP) surgery and non-HP (labyrinthectomy) surgery groups.
• Examination of tinnitus occurrence, loudness, and annoyance in relation to surgical technique and preoperative status.

Main Results:

• Postoperative tinnitus increased in the HP group (78.6% to 89.3%, p=0.0367), while it decreased in the non-HP group (72.7% to 67.3%, p=0.4097).
• 85% of HP patients without preoperative tinnitus developed it postoperatively, versus 31% in the non-HP group.
• Hearing preservation outcome did not affect postoperative tinnitus loudness or annoyance.

Conclusions:

• Hearing preservation surgery for acoustic neuroma significantly increases the risk of developing or worsening tinnitus.
• Patients undergoing acoustic neuroma resection, especially with hearing preservation goals, should be counseled about the high likelihood of postoperative tinnitus.
• While generally tolerable, the potential for new or exacerbated tinnitus necessitates informed consent prior to surgery.