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

Zhang, Chi; Wang, Fangyuan; Cao, Wenluo; Ma, Xiaoyan; Chen, Jiyue; Shen, Wei-Dong; Yang, Shi‐Ming

doi:10.1080/00016489.2020.1869304

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…Postoperative new-onset tinnitus is a special type of tinnitus that changes after surgery. Approximately, 22% of VS patients appeared tinnitus after surgery [ 12 , 23 ], and in our study, it was 18.2%. Zhang et al [ 23 ] found that patients with lower PTA had a higher incidence of new-onset tinnitus.…”

Section: Discussionsupporting

confidence: 49%

“…Approximately, 22% of VS patients appeared tinnitus after surgery [ 12 , 23 ], and in our study, it was 18.2%. Zhang et al [ 23 ] found that patients with lower PTA had a higher incidence of new-onset tinnitus. We also found that patients with serviceable preoperative hearing were more likely to experience new-onset tinnitus after surgery.…”

Section: Discussionsupporting

confidence: 49%

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Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study

You,

Zhang,

Zhang

et al. 2024

Chin Neurosurg Jl

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Background Tinnitus is very common in patients with vestibular schwannoma (VS). We analyzed the related factors of tinnitus after surgery. Methods One hundred seventy-three patients diagnosed with unilateral VS operated via the retrosigmoid approach were included in the study. All patients underwent relevant examinations and completed the THI scale before surgery and 6 months after surgery. The prognosis of tinnitus was evaluated according to the changes in THI. Results Of the 129 preoperative tinnitus patients, postoperative tinnitus resolved in 12.4%, improved in 29.5%, remained unchanged in 28.6%, and worsened in 29.5%. 18.2% of 44 patients without preoperative tinnitus appeared new-onset tinnitus postoperatively. Thirty-six patients never had tinnitus. Patients with smaller tumor sizes (≤ 3 cm) were more likely to experience preoperative tinnitus. Younger patients and those with serviceable hearing preoperatively were more likely to report their tinnitus unchanged or worsened. A new onset of postoperative tinnitus in the preoperative non-tinnitus group was found in better preoperative hearing function. Conclusions In this study, 70% of patients had persistent tinnitus after vestibular schwannoma resection. The prognosis of tinnitus was influenced by age and preoperative hearing function. Tinnitus is a bothersome symptom and is often underestimated by doctors. Assessment of tinnitus is mandatory during the management of vestibular schwannoma.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionsupporting

confidence: 49%

Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study

You,

Zhang,

Zhang

et al. 2024

Chin Neurosurg Jl

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“…Comparisons between hearing sparing versus non-hearing sparing approaches have shown that tinnitus outcomes are better in patients treated by a translabyrintine approach than in those treated by a retrosigmoid approach, confirming the hypothesis that cochlear nerve interruption is a positive predictor of tinnitus resolution [ 98 ] Conversely, other studies deny the existence of an association between type of surgery and tinnitus resolution, suggesting that the maintenance mechanism of tinnitus is to be traced to the brainstem and central nervous system above the brainstem and not to the more peripheral structures [ 91 , 99 , 100 ]. Other factors seemingly associated with a higher likelihood of either tinnitus resolution or improvement include age > 50 years and nonserviceable preoperative hearing.…”

Section: Resultsmentioning

confidence: 81%

Factors Influencing Personalized Management of Vestibular Schwannoma: A Systematic Review

Sergi

Settimi

Federici

et al. 2022

JPM

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Management of vestibular schwannoma (VS) is a complex process aimed at identifying a clinical indication for fractionated stereotactic radiotherapy (sRT) or microsurgical resection or wait and scan (WS). The aim of the review was to clarify which patient and tumor parameters may lead to different therapeutic choices, with a view to a personalized VS approach. A systematic review according to Preferred Reporting Items for Systematic Review and Meta-Analysis criteria was conducted between February and March 2022. The authors defined six parameters that seemed to influence decision-making in VS management: 1-incidental VS; 2-tumor size; 3-tumor regrowth after sRT; 4-subtotal resection; 5-patients’ age; 6-symptoms. The initial search yielded 3532 articles, and finally, 812 articles were included. Through a qualitative synthesis of the included studies, management strategies were evaluated and discussed. An individualized proposal of procedures is preferable as compared to a single gold-standard approach in VS decision-making. The most significant factors that need to be considered when dealing with a VS diagnosis are age, tumor size and hearing preservation issues.

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“…Zhang et al conducted a study on 237 patients who underwent VS surgery and had pre-operative tinnitus, and 90 patients who did not have tinnitus [ 29 ]. Translabyrinthine (TL) and retro sigmoid (RS) approaches were used in the included patients.…”

Section: Resultsmentioning

confidence: 99%

“…This assessment was completed by two reviewers (J.C., A.K.) independently, with discrepancies resolved by discussion and consensus or discussion with the senior author [ 6 , 19 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Section: Methodsmentioning

confidence: 99%

Vestibular Schwannoma and Tinnitus: A Systematic Review of Microsurgery Compared to Gamma Knife Radiosurgery

King,

Cooper,

Oganezova

et al. 2024

JCM

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Background: Vestibular schwannoma (VS) is a benign tumor of the eighth cranial nerve formed from neoplastic Schwann cells. Although VS can cause a variety of symptoms, tinnitus is one of the most distressing symptoms for patients and can greatly impact quality of life. The objective of this systematic review is to comprehensively examine and compare the outcomes related to tinnitus in patients undergoing treatment for VS. Specifically, it evaluates patient experiences with tinnitus following the removal of VS using the various surgical approaches of traditional surgical resection and gamma knife radiosurgery (GKS). By delving into various aspects such as the severity of tinnitus post-treatment, the duration of symptom relief, patient quality of life, new onset of tinnitus after VS treatment, and any potential complications or side effects, this review aims to provide a detailed analysis of VS treatment on tinnitus outcomes. Methods: Following PRISMA guidelines, articles were included from PubMed, Science Direct, Scopus, and EMBASE. Quality assessment and risk of bias analysis were performed using a ROBINS-I tool. Results: Although VS-associated tinnitus is variable in its intensity and persistence post-resection, there was a trend towards a decreased tinnitus burden in patients. Irrespective of the surgical approach or the treatment with GKS, there were cases of persistent or worsened tinnitus within the studied cohorts. Conclusion: The findings of this systematic review highlight the complex relationship between VS resection and tinnitus outcomes. These findings underscore the need for individualized patient counseling and tailored treatment approaches in managing VS-associated tinnitus. The findings of this systematic review may help in guiding clinicians towards making more informed and personalized healthcare decisions. Further studies must be completed to fill gaps in the current literature.

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

Cited by 7 publications

References 20 publications

Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study

Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study

Factors Influencing Personalized Management of Vestibular Schwannoma: A Systematic Review

Vestibular Schwannoma and Tinnitus: A Systematic Review of Microsurgery Compared to Gamma Knife Radiosurgery

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