Change in tinnitus after treatment of vestibular schwannoma: Microsurgery vs. Gamma knife radiosurgery

Soon Hyung Park, Hee So Oh, Ju Hyun Jeon, Yong Ju Lee, InSeok Moon, Won Sang Lee

Research output: Contribution to journalArticle

9 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)19-24
Number of pages6
JournalYonsei medical journal
Volume55
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

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Acoustic Neuroma
Microsurgery
Tinnitus
Radiosurgery
Visual Analog Scale
Vestibulocochlear Nerve
Therapeutics
Hearing
Equipment and Supplies
Tumor Burden
Pure-Tone Audiometry
Cochlear Nerve
Cochlea

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Park, Soon Hyung ; Oh, Hee So ; Jeon, Ju Hyun ; Lee, Yong Ju ; Moon, InSeok ; Lee, Won Sang. / Change in tinnitus after treatment of vestibular schwannoma : Microsurgery vs. Gamma knife radiosurgery. In: Yonsei medical journal. 2014 ; Vol. 55, No. 1. pp. 19-24.
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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.",
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Change in tinnitus after treatment of vestibular schwannoma : Microsurgery vs. Gamma knife radiosurgery. / Park, Soon Hyung; Oh, Hee So; Jeon, Ju Hyun; Lee, Yong Ju; Moon, InSeok; Lee, Won Sang.

In: Yonsei medical journal, Vol. 55, No. 1, 01.01.2014, p. 19-24.

Research output: Contribution to journalArticle

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T2 - Microsurgery vs. Gamma knife radiosurgery

AU - Park, Soon Hyung

AU - Oh, Hee So

AU - Jeon, Ju Hyun

AU - Lee, Yong Ju

AU - Moon, InSeok

AU - Lee, Won Sang

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N2 - 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.

AB - 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.

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