Translabyrinthine vestibular schwannoma surgery: postoperative tinnitus and cochlear nerve integrity

Harcourt, Jonathan; Thomsen, Jens; Tos, Mirko

doi:10.1016/s0385-8146(96)00040-5

Cited by 30 publications

(22 citation statements)

References 5 publications

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“…Another study reported reduction in tinnitus severity in 45% of patients who underwent the middle cranial fossa approach 12. Harcourt, et al13 investigated change in tinnitus after TLM and reported that patients who had probable or definite cochlear nerve section had significantly lower postoperative tinnitus severity. In addition, it was found that cochlear neurectomy improved tinnitus control rates compared to vestibular nerve section alone 14.…”

Section: Discussionmentioning

confidence: 99%

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

Park

Jeon

et al. 2014

Yonsei Med J

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PurposeTinnitus 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 MethodsAmong 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.ResultsIn 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.ConclusionGKS 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.

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Section: Discussionmentioning

confidence: 99%

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

Park

Jeon

et al. 2014

Yonsei Med J

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“…What could be more helpful is the comparison of preoperative and postoperative tinnitus in order to estimate the surgery's effect. Some studies have noted the beneficial effect of cochlear nerve section, in regards to tinnitus [41][42][43]. Specifically, Harcourt et al [42] reached the conclusion that, patients who had a probable or definite nerve section had significantly lower postoperative tinnitus severity, and that the same relationship was found when patients were matched for tumor size and preoperative tinnitus.…”

Section: Tinnitusmentioning

confidence: 99%

“…Severity of headaches can be assessed based on the following classification: 0/no headache, 1/minor headache requiring over-the-counter medication, 2/headache requiring prescription medication and 3/headache refractory to prescription medication [44,51]. Some patients benefit from the use of sumatriptan [42] with even complete eradication of the headaches. This exceptional effect of sumatriptan suggests a trigeminal nerve-mediated cause of postoperative headaches.…”

Section: Headachementioning

confidence: 99%

Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management

Charalampakis¹,

Koutsimpelas²,

Gouveris³

et al. 2011

Eur Arch Otorhinolaryngol

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The retrosigmoid (suboccipital) approach is one of four surgical approaches for the treatment of vestibular schwannomas (acoustic neuromas). It is increasingly used by otologic surgeons, and in experienced hands is associated with improved results and more limited complications. Mortality rates are minimal and often zero, while postoperative sequelae, on the other hand, are not rare. In order to not only save the patient's life, but also to assure good quality of life after the surgery, one must consider many different aspects of management of the respective complications. In this review the issues of current management of CSF leak and meningitis, facial paresis, headache, hearing loss, unsteadiness, disequilibrium, vertigo, tinnitus, cerebellar and brain stem injuries or abscess, vascular complications and venous air embolism after retrosigmoid approach for removal of vestibular schwannomas are presented.

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“…If you did not have tinnitus in the ear with tumor prior to surgery, how loud is the tinnitus in that ear now? a. not heard b. barely noticeable c. mild d. moderate e. loud f. very loud 6. How great is the annoyance you feel from tinnitus in the operated ear now?…”

Section: Patient Populationmentioning

confidence: 99%

Does Hearing Preservation Surgery for Acoustic Neuromas Affect Tinnitus?

Kanzaki¹,

Satoh²,

Kunihiro³

1999

Skull Base

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ABSTRACT-Questionnaires retuned from 202 patients who had -undergone acoustic neuroma resection were analyzed with special reference to the effect on tinnitus of surgery that attempted to preserve hearing versus surgery that did not. We also examined the relationship between postoperative hearing and tinnitus following surgery to -preserve hearing (103 patients, HP group). Tinnitus, one of the most common symptoms of an acoustic neuroma. may be the initial symptom leading to its diagnosis. The literature indicates that tinnitus occurs in 60-80% of the patients preoperatively.1-6 However, few comprehensive studies have been carried out on its postoperative occurrence.24.6.7 Preoperative counseling of the patients also tends to ignore tinnitus as a possible side effect, concentrating primarily on the rates of mortality and serious morbidity. This apparent medical indifference can be explained in part by the impossibility of measuring this subjective complaint and the difficulty of describing and classifying it. Recent advances in diagnostic and surgical techniques have, however, drastically reduced the mortality and morbidity rates associated with tumor resection. Consequently, postoperative tinnitus has increased in importance as a factor affecting the patient's quality of life.We analyzed the effect of acoustic neuroma resection via the (extended) middle cranial fossa approach on postoperative tinnitus. The analyses were made with special reference to the effect on tinnitus of attempted hearing preservation versus nonhearing preservation surgery. In light of these results, we discuss the rationale for attempting to preserve hearing when surgically treating acoustic neuromas.

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Translabyrinthine vestibular schwannoma surgery: postoperative tinnitus and cochlear nerve integrity

Cited by 30 publications

References 5 publications

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

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

Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management

Does Hearing Preservation Surgery for Acoustic Neuromas Affect Tinnitus?

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