How does stapes surgery influence severe disabling tinnitus in otosclerosis patients?

Tinnitus is a common symptom in otosclerosis patients. Many papers have been written about tinnitus outcome after stapes surgery. However, none has attempted to quantify the intensity of the symptom pre- and postoperatively in order to evaluate the influence of surgery on the degree of annoyance caused by tinnitus. Severe disabling tinnitus (SDT) is defined by Shulman as a symptom severe enough to disrupt the patient's routine and to prevent him from performing his daily tasks. We have studied 48 consecutive otosclerosis patients by means of a visual analogue scale measuring tinnitus intensity before and after stapes surgery. We have accepted tinnitus as severe and disabling when the symptom score was 7 or above in a visual analogue scale from 1 to 10. Of 19 patients with preoperative SDT, 10 reported complete remission and 7 reported significant improvement. Two patients had no change and none reported worsening of tinnitus after stapes surgery. We conclude that stapes surgery can improve SDT significantly in 90% of otosclerosis patients and is very unlikely to make the symptom worse.