Acoustic neuroma surgery and tinnitus.

The objectives of this study were to assess the effect that acoustic neuroma surgery has on tinnitus and to investigate possible predictors (tumour size and patients' ages at operation) as well as to ascertain if the overall quality of life in patients with acoustic neuromas is affected by their tinnitus. A questionnaire was sent to randomly selected patients post acoustic-neuroma surgery. This was based on the Glasgow Benefit Inventory and contained a standardised series of four functional gradings for tinnitus. In this study, 51 patients from a total of 68 returned the questionnaire, and there was a follow-up period of between 1 and 3 years following the acoustic neuroma surgery. The age at operation, size of the tumour and overall quality of life were correlated with the impact of surgery on tinnitus. Statistical analysis used the one-way analysis of variance, chi-square test, one-way analysis by ranks and Spearman Rank Correlations. Significance was accepted at the P<0.05 level. Overall, 30 (58.8%) of the patients had tinnitus preoperatively in comparison to 34 (66.6%) postoperatively. After surgery, tinnitus became better in 8 (16%) patients, 28 (55%) did not experience any change, and 15 (29%) became worse. Neither tumour size nor age at the time of the operation had a statistically significant association with the impact of surgery on tinnitus. There was no statistically significant association between changes in tinnitus status and changes in the quality of life following the operation ( P>0.05). A significant percentage of patients with acoustic neuromas, approximately 60%, suffer from tinnitus preoperatively, and this number may increase slightly postoperatively. It remains unpredictable which patients will improve, which will show no change and which will deteriorate as age and tumour size do not seem to be associated with the impact of surgery on tinnitus. The results also suggest that tinnitus may be of relatively minor importance in the overall quality of life of patients following acoustic neuroma surgery. However, candidates for surgery should be thoroughly informed about the possible effect of the operation on their tinnitus status.