The purpose of this investigation was to study the effects of translabyrinthine acoustic neuroma surgery on tinnitus in a consecutive sample of patients operated on between 1988 and 1994 in Uppsala (Sweden). A postal questionnaire was returned by 141 patients, yielding a 90% response rate without reminder. The results showed that tinnitus was experienced by 70% of the patients before surgery and 60% after surgery. In general, low degrees of tinnitus distress were found, which was confirmed by the questionnaire results. Ratings of tinnitus distress after surgery, using the Klockhoff and Lindblom grading system, showed that 48% had tinnitus of grade I, 46% of grade II, and 6% of grade III. Pre- and postsurgery grading of distress did not change significantly. There was a 35% risk for developing tinnitus when no preoperative tinnitus was present and a 15 % chance that tinnitus disappears when present preoperatively.
Surgical removal of facial neuroma is a safe procedure with a low complication rate and a low recurrence rate. First symptoms are diverse and are predominantly derived from the facial and vestibulocochlear nerve. Facial nerve grafting is reliable, giving the patient an acceptable facial nerve function (HB III).
At present there is no universally accepted method for calculating hearing results after chronic ear surgery. In this study the methods most frequently used have been applied to a material of 105 tympanoplasties and compared to each other. In addition a comparison between pre- and post-operative bone conductions (BC) thresholds for calculating post-operative air-bone gaps has been performed using multiple regression analysis. The results lend support to the conclusion that BC thresholds will improve with surgery in successful cases and that the post-operative BC threshold is a closer approximation of the cochlear function than the pre-operative one and consequently should be used for gap calculations. However, until the masking procedures in audiometry are standardized, hearing gain may be regarded as the most satisfactory alternative for describing hearing results as it is based on the air conduction thresholds only. This method requires a careful description of pre-operative air and bone conduction thresholds.
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