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You N, Zhang J, Zhang D, Zhao Y, Zhang J, Xu B. Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study. Chin Neurosurg J 2024; 10:10. [PMID: 38566173 PMCID: PMC10988867 DOI: 10.1186/s41016-024-00363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
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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Affiliation(s)
- Na You
- Medical School of Chinese PLA, Beijing, China
- Department of Neurosurgery, First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jiashu Zhang
- Department of Neurosurgery, First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Ding Zhang
- Department of Neurosurgery, First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yue Zhao
- Department of Neurosurgery, First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jun Zhang
- Department of Neurosurgery, First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Bainan Xu
- Department of Neurosurgery, First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
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Lin J, You N, Li X, Huang J, Wu H, Lu H, Hu J, Zhang J, Lou X. Atypical functional hierarchy contributed to the tinnitus symptoms in patients with vestibular schwannoma. Front Neurosci 2023; 17:1084270. [PMID: 36875656 PMCID: PMC9982843 DOI: 10.3389/fnins.2023.1084270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/03/2023] [Indexed: 02/22/2023] Open
Abstract
Objective Tinnitus is frequently found in patients with vestibular schwannoma (VS), but its underlying mechanisms are currently unclear. Methods Both preoperative (VS pre ) and postoperative (VS post ) functional MR images were collected from 32 patients with unilateral VS and matched healthy controls (HCs). Connectome gradients were generated for the identification of altered regions and perturbed gradient distances. Tinnitus measurements were conducted for predictive analysis with neuroimaging-genetic integration analysis. Results There were 56.25% of preoperative patients and 65.63% of postoperative patients suffering from ipsilateral tinnitus, respectively. No relevant factors were identified including basic demographics info, hearing performances, tumor features, and surgical approaches. Functional gradient analysis confirmed atypical functional features of visual areas in VS pre were rescued after tumor resection, while the gradient performance in the postcentral gyrus continues to maintain (VS post vs. HC : P = 0.016). The gradient features of the postcentral gyrus were not only significantly decreased in patients with tinnitus (P FDR = 0.022), but also significantly correlated with tinnitus handicap inventory (THI) score (r = -0.30, P = 0.013), THI level (r = -0.31, P = 0.010), and visual analog scale (VAS) rating (r = -0.31, P = 0.0093), which could be used to predict VAS rating in the linear model. Neuropathophysiological features linked to the tinnitus gradient framework were linked to Ribosome dysfunction and oxidative phosphorylation. Conclusion Altered functional plasticity in the central nervous system is involved in the maintenance of VS tinnitus.
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Affiliation(s)
- Jiaji Lin
- Department of Radiology, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
| | - Na You
- Department of Neurosurgery, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
| | - Xiaolong Li
- Department of Radiology, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
| | - Jiayu Huang
- Department of Radiology, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
| | - Haoyang Wu
- Basic Medicine School, Air Force Military Medical University, Xi'an, China
| | - Haoxuan Lu
- Department of Radiology, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
| | - Jianxing Hu
- Department of Radiology, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
| | - Jun Zhang
- Department of Neurosurgery, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
| | - Xin Lou
- Department of Radiology, Chinese People's Liberation Army General Hospital/Medical School of Chinese People's Liberation Army, Beijing, China
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Abstract
Posterior fossa meningiomas that impinge on structures of the temporal bone or clivus may be difficult to access for optimal resection that maximizes tumor control and minimizes short- and long-term morbidities. To address this challenge, the contemporary neurosurgery-neurotology team works collaboratively by managing patients jointly at every stage of care: preoperative evaluation, intraoperative intervention, and postoperative treatment. The neurotologist is important at all stages of posterior fossa meningioma surgery. First, detailed preoperative evaluation of auditory, facial, vestibular, and lower cranial nerve integrity enables assessment of new neurologic deficit risk, prognosis of functional recovery, and pros and cons of candidate surgical approaches. Second, intraoperative partitioning of surgical steps by provider and adopting an overlapping tumor resection philosophy creates an efficient and confident surgical team built on trust. Third, postoperative closure of cerebrospinal fluid leak and treatment of facial weakness, audiovestibular dysfunction, and voicing and swallowing impairments organized by the neurotologist reduces the impact of negative outcomes. The role of the neurotologist in posterior fossa meningioma surgery is to deliver nuanced evaluative metrics, facilitate shared decision making, perform precise bone and soft tissue microsurgery, and mitigate perioperative morbidities.
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Zhang C, Wang F, Cao W, Ma X, Chen J, Shen W, Yang S. Identification of factors associated with tinnitus outcomes following the microsurgical treatment of vestibular schwannoma patients. Acta Otolaryngol 2021; 141:334-339. [PMID: 33439063 DOI: 10.1080/00016489.2020.1869304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Tinnitus is common in vestibular schwannoma patients, but the postoperative tinnitus status of these patients and related factors remain unclear. AIMS To identify preoperative and operative factors associated with postoperative tinnitus status. MATERIALS AND METHODS Postoperative outcomes were retrospectively assessed in 237 vestibular schwannomas (VS) patients with preoperative tinnitus and 90 VS patients without tinnitus. RESULTS When evaluating patients with preoperative tinnitus, there were significant differences in rates of improvement, no change, and worsening of tinnitus for the translabyrinthine (TL) and retrosigmoid (RS) approaches. Of patients without preoperative tinnitus, there was a significant difference in rates of not developing tinnitus and new-onset tinnitus. Similar results were observed with respect to preoperative hearing. Least-squares analyses revealed that surgical approach and preoperative hearing were independent predictors of postoperative tinnitus. Preoperative pure tone averages for TL group patients that did not develop postoperative tinnitus were 85.8 dB, whereas in patients that developed new-onset tinnitus they were significantly lower (54.9 dB). CONCLUSIONS AND SIGNIFICANCE Tinnitus prognosis in VS patients is better following TL microsurgery relative to RS microsurgery and is also better in patients with worse preoperative hearing. New-onset tinnitus was more likely to occur in patients with better preoperative hearing that underwent tumor removal via a TL approach.
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Affiliation(s)
- Chi Zhang
- Medical School of Chinese PLA, Beijing, China
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- Ministry of Education, State Key Lab of Hearing Science, Beijing, China
| | - Fangyuan Wang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- Ministry of Education, State Key Lab of Hearing Science, Beijing, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Wei Cao
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- Ministry of Education, State Key Lab of Hearing Science, Beijing, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Xiaoyan Ma
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- Ministry of Education, State Key Lab of Hearing Science, Beijing, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Jiyue Chen
- Medical School of Chinese PLA, Beijing, China
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- Ministry of Education, State Key Lab of Hearing Science, Beijing, China
| | - Weidong Shen
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- Ministry of Education, State Key Lab of Hearing Science, Beijing, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Shiming Yang
- Medical School of Chinese PLA, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- Ministry of Education, State Key Lab of Hearing Science, Beijing, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
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Barnes JH, Patel NS, Lohse CM, Tombers NM, Link MJ, Carlson ML. Impact of Treatment on Vestibular Schwannoma-Associated Symptoms: A Prospective Study Comparing Treatment Modalities. Otolaryngol Head Neck Surg 2021; 165:458-464. [PMID: 33494647 DOI: 10.1177/0194599820986564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The degree to which various treatment modalities modify vestibular schwannoma (VS)-associated symptoms has received limited attention. The purpose of this study was to determine how different treatment modalities affect subjective symptoms in those presenting with VS. STUDY DESIGN Prospective survey. SETTING Tertiary neurotology referral center. METHODS Patients with sporadic VS who received treatment at our institution were prospectively surveyed with a VS symptom questionnaire. Those who completed a baseline survey prior to treatment and at least 1 posttreatment survey were included. The prospective survey evaluated the severity of self-reported symptoms (Likert scale, 1-10), including tinnitus, dizziness or imbalance, headaches, and hearing loss. RESULTS A total of 244 patients were included (mean age, 57 years). The mean duration of follow-up was 2.1 years, and the median number of surveys completed was 2 (interquartile range, 1-3). Seventy-eight (32%) cases were managed with observation, 118 (48%) with microsurgery, and 48 (20%) with radiosurgery. Multivariable analyses revealed no statistically significant difference in the change in tinnitus (P = .15), dizziness or imbalance (P = 0.66), or headaches (P = .24) among treatment groups. Evaluation of clinically important differences demonstrated that microsurgery leads to significant bidirectional changes in headaches. CONCLUSIONS Limited prospective data exist regarding the progression or resolution of subjective symptoms in those presenting with VS. This study suggests that tinnitus, dizziness or imbalance, and headaches are unlikely to be significantly modified by treatment modality and generally should not be used to direct treatment choice.
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Affiliation(s)
- Jason H Barnes
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Neil S Patel
- Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Christine M Lohse
- Department of Health Science Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicole M Tombers
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J Link
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Kitamura M, Oishi N, Suzuki N, Kojima T, Nishiyama T, Noguchi M, Hosoya M, Ogawa K. Management of tinnitus in patients with vestibular schwannoma who underwent surgical resection. Eur Arch Otorhinolaryngol 2021; 278:4243-4249. [PMID: 33386435 DOI: 10.1007/s00405-020-06531-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/27/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate tinnitus and its management in patients with vestibular schwannoma (VS) who underwent surgery, we investigate the effect of surgical approach or residual hearing on tinnitus severity and the effects of intervention for tinnitus including educational counseling, sound therapy using hearing aids (HAs), and medication (selective serotonin reuptake inhibitors, and SSRIs). METHODS Seventy-one subjects of VS patients who underwent surgery were included. Their tinnitus severity was evaluated using the Japanese version of the Tinnitus Handicap Inventory (THI). The relationships between postoperative THI scores and surgery types or residual hearing levels were examined. We also examined longitudinal changes in THI scores and the efficacy of the intervention. RESULTS Surgery approach, hearing preservation or hearing loss surgery, and residual hearing levels were not significantly related to the postoperative tinnitus severity. In 71 cases, 45 cases did not require any management for tinnitus. On the contrary, 26 patients had at least one episode of tinnitus distress (THI score was greater than or equal to 18). Educational counseling alone was found to be effective in 17 cases out of the 26 cases, and the remaining 9 cases required more intervention than educational counseling alone. We selected sound therapy with HA for 7 cases and administration of SSRI for 2 cases, which was found to be highly effective in 8 cases. CONCLUSION Based on the present study, we consider that appropriate management may be possible for tinnitus in the majority of VS patients who underwent surgery.
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Affiliation(s)
- Mitsuru Kitamura
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Naoki Oishi
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan.
| | - Noriomi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Takashi Kojima
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Takanori Nishiyama
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Masuru Noguchi
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Makoto Hosoya
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Kaoru Ogawa
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, 160-8582 Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
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Henderson-Sabes J, Shang Y, Perez PL, Chang JL, Pross SE, Findlay AM, Mizuiri D, Hinkley LB, Nagarajan SS, Cheung SW. Corticostriatal functional connectivity of bothersome tinnitus in single-sided deafness. Sci Rep 2019; 9:19552. [PMID: 31863033 DOI: 10.1038/s41598-019-56127-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/06/2019] [Indexed: 02/06/2023] Open
Abstract
Subjective tinnitus is an auditory phantom perceptual disorder without an objective biomarker. Bothersome tinnitus in single-sided deafness (SSD) is particularly challenging to treat because the deaf ear can no longer be stimulated by acoustic means. We contrasted an SSD cohort with bothersome tinnitus (TIN; N = 15) against an SSD cohort with no or non-bothersome tinnitus (NO TIN; N = 15) using resting-state functional magnetic resonance imaging (fMRI). All study participants had normal hearing in one ear and severe or profound hearing loss in the other. We evaluated corticostriatal functional connectivity differences by placing seeds in the caudate nucleus and Heschl’s Gyrus (HG) of both hemispheres. The TIN cohort showed increased functional connectivity between the left caudate and left HG, and left and right HG and the left caudate. Within the TIN cohort, functional connectivity between the right caudate and cuneus was correlated with the Tinnitus Functional Index (TFI) relaxation subscale. And, functional connectivity between the right caudate and superior lateral occipital cortex, and the right caudate and anterior supramarginal gyrus were correlated with the TFI control subscale. These findings support a striatal gating model of tinnitus and suggest tinnitus biomarkers to monitor treatment response and to target specific brain areas for innovative neuromodulation therapies.
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Udawatta M, Kwan I, Preet K, Nguyen T, Ong V, Sheppard JP, Duong C, Romiyo P, Lee P, Tenn S, Kaprealian T, Gopen Q, Yang I. Hearing Preservation for Vestibular Schwannomas Treated with Stereotactic Radiosurgery or Fractionated Stereotactic Radiotherapy. World Neurosurg 2019; 129:e303-e310. [PMID: 31132496 DOI: 10.1016/j.wneu.2019.05.133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Vestibular schwannomas (VS) are benign intracranial neoplasms arising from the eighth cranial nerve for which targeted radiation therapy (RT) has proved increasingly successful. However, long-term hearing and related cranial nerve outcomes have been disputed for the 3 current RT modalities. OBJECTIVE To determine differences in hearing preservation for patients treated with stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (FSRT), or hypofractionated stereotactic radiotherapy (hypoFSRT) for VS. METHODS A retrospective electronic chart review was conducted for all patients with unilateral VS treated with primary RT at a single academic medical center between 2000 and 2017. The primary outcome measure was preservation of serviceable hearing status in the affected ear at last follow-up. Secondary outcomes included tinnitus, vertigo, and imbalance. RESULTS A total of 33 FSRT cases, 21 SRS cases, and 6 hypoFSRT cases were identified. Postoperative deterioration in serviceable hearing and tinnitus showed significant differences across cohorts. The SRS cohort had a higher baseline incidence of nonserviceable hearing and disequilibrium compared with other cohorts before RT (P = 0.001 and 0.022, respectively); no differences in baseline morbidity were observed for vertigo and tinnitus. The 5-year tumor control rate was 95.2%, 93.9%, and 100% with SRS, FSRT, and hypoFSRT, respectively. CONCLUSIONS Our series indicated an excellent tumor control rate in all the modalities. Our SRS cohort showed increased incidence and shorter time to hearing deterioration compared with the FSRT and hypoFSRT cohorts. The FSRT and hypoFSRT cohorts have shown comparable overall outcomes. Onset of post-RT tinnitus was observed only with FSRT.
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Affiliation(s)
- Methma Udawatta
- Department of Neurosurgery, University of California, Los Angeles, California, USA; David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Isabelle Kwan
- Department of Neurosurgery, University of California, Los Angeles, California, USA
| | - Komal Preet
- Department of Neurosurgery, University of California, Los Angeles, California, USA; David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Thien Nguyen
- Department of Neurosurgery, University of California, Los Angeles, California, USA; David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Vera Ong
- Department of Neurosurgery, University of California, Los Angeles, California, USA
| | - John P Sheppard
- Department of Neurosurgery, University of California, Los Angeles, California, USA; David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Courtney Duong
- Department of Neurosurgery, University of California, Los Angeles, California, USA
| | - Prasanth Romiyo
- Department of Neurosurgery, University of California, Los Angeles, California, USA
| | - Percy Lee
- Department of Radiation Oncology, University of California, Los Angeles, California, USA
| | - Stephen Tenn
- Department of Radiation Oncology, University of California, Los Angeles, California, USA
| | - Tania Kaprealian
- Department of Neurosurgery, University of California, Los Angeles, California, USA; Department of Radiation Oncology, University of California, Los Angeles, California, USA; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, USA
| | - Quinton Gopen
- Department of Head and Neck Surgery, University of California, Los Angeles, California, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, California, USA; Department of Radiation Oncology, University of California, Los Angeles, California, USA; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, USA; Los Angeles Biomedical Research Institute, University of California, Los Angeles, California, USA; Harbor-UCLA Medical Center, University of California, Los Angeles, California, USA; David Geffen School of Medicine, University of California, Los Angeles, California, USA.
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Wang JJ, Feng YM, Wang H, Wu YQ, Shi HB, Chen ZN, Yin SK. Changes in tinnitus after vestibular schwannoma surgery. Sci Rep 2019; 9:1743. [PMID: 30742012 PMCID: PMC6370768 DOI: 10.1038/s41598-019-38582-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/03/2019] [Indexed: 01/18/2023] Open
Abstract
We designed a prospective study to evaluate changes in tinnitus after vestibular schwannoma (VS) surgery. Subjects included 41 patients who were diagnosed with a VS and underwent translabyrinthine microsurgery (TLM) between January 2015 and May 2016. All patients underwent related examinations and were asked to answer the Tinnitus Handicap Inventory (THI) scale and a visual analog scale (VAS) of tinnitus severity both pre- and postoperatively. Of the 41 patients, 31 (75.6%) suffered from tinnitus before surgery. Microsurgery was associated with an overall decrease in tinnitus (p < 0.001). There was a significant improvement in THI and VAS scores after surgery (p = 0.001 and p = 0.005, respectively). The decrease in THI scores in the low-frequency group was significantly larger than that of the mid- and high-frequency groups after surgery (p = 0.034 and p = 0.001, respectively). The loudness of tinnitus decreased significantly after surgery (p = 0.031). Tinnitus in patients with VS improved after TLM. Patients with mid-/high-frequency tinnitus and louder tinnitus preoperatively seemed to have a worse prognosis than those with low-frequency and quieter tinnitus.
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Affiliation(s)
- Jing-Jing Wang
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Yan-Mei Feng
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Hui Wang
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Ya-Qin Wu
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Hai-Bo Shi
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Zheng-Nong Chen
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China.
| | - Shan-Kai Yin
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China.
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Wrzosek M, Szymiec E, Klemens W, Kotyło P, Schlee W, Modrzyńska M, Lang-Małecka A, Preis A, Bulla J. Polish Translation and Validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index. Front Psychol 2016; 7:1871. [PMID: 27965609 PMCID: PMC5126044 DOI: 10.3389/fpsyg.2016.01871] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/14/2016] [Indexed: 01/05/2023] Open
Abstract
Objective: The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to translate into Polish and to validate two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). Design: The original English versions of the questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl) and a Polish TFI (TFI-Pl). Participants from three laryngological centers in Poland anonymously answered the THI-Pl (N = 98) and the TFI-Pl (N = 108) in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale as a measure of self-perceived level of depression, and the Satisfaction With Life Scale to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity. Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach's α = 0.93). The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic, and emotional subscales. Convergent and discriminant validities were confirmed. The TFI-Pl showed high internal consistency (Cronbach's α = 0.96) with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validities were also confirmed for the TFI-Pl. Conclusion: We translated and validated the Polish versions of the THI and the TFI to make them suitable for clinical use in Poland.
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Affiliation(s)
- Małgorzata Wrzosek
- Department of Logic and Cognitive Science, Adam Mickiewicz University Poznań, Poland
| | | | | | - Piotr Kotyło
- Audiology and Phoniatrics Clinic, Nofer Institute of Occupational Medicine in Łódź Łódź, Poland
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg Regensburg, Germany
| | | | | | - Anna Preis
- Institute of Acoustics, Adam Mickiewicz University Poznań, Poland
| | - Jan Bulla
- Department of Mathematics, University of Bergen Bergen, Norway
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