Tinnitus Suppression After Auditory Brainstem Implantation in Patients With Neurofibromatosis Type-2.

Abstract

OBJECTIVE:

To evaluate whether an auditory brainstem implant (ABI) can impact levels of tinnitus in neurofibromatosis type-2 (NF2) patients who have undergone translabyrinthine craniotomy for vestibular schwannoma (VS) removal and to evaluate the burden of tinnitus in these patients.

STUDY DESIGN:

A retrospective case series and patient survey.

SETTING:

Tertiary neurotologic referral center.

PATIENTS:

NF2 patients who underwent translabyrinthine removal of VS and ABI placement between 1994 and 2015.

INTERVENTIONS:

A survey, retrospective review and two validated tinnitus handicap questionnaires (tinnitus handicap inventory [THI] and tinnitus visual analogue scale [VAS]) were used to characterize the degree of tinnitus in NF2 patients and whether an ABI can alter tinnitus levels.

MAIN OUTCOME MEASURES(S):

Survey results, THI and VAS scores.

RESULTS:

One hundred twelve ABI users were contacted and 43 patients (38.3)% responded to our survey. Tinnitus was reported in 83.7% of patients. The THI score for responders was 17.8 ± 20.5 standard deviation (SD). For survey participants, the ABI reduced tinnitus levels (mean VAS: Off = 3.5; On 1-h = 2.1; p = 0.048). For patients who subjectively reported that the ABI reduced tinnitus loudness, tinnitus levels were immediately reduced on ABI activation and after 1 hour of use (mean VAS: Off = 4.8; On = 2.4; On 1-h = 1.8; p < 0.01). Suppression did not continue after the device was turned off. Audiological performance with the ABI did not correlate with tinnitus suppression.

CONCLUSION:

NF2 patients who have undergone removal of VS have a significant tinnitus handicap and benefit from tinnitus suppression through utilization of an ABI possibly through masking or electrical stimulation of the auditory brainstem.

• Authors: Daniel S Roberts, Steve Otto, Brian Chen, Kevin A Peng, Marc S Schwartz, Derald E Brackmann, John W House
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 38 Issue 1 Pg. 118-122 (01 2017) ISSN: 1537-4505 [Electronic] United States
• PMID: 27755361 (Publication Type: Journal Article)

Topics

• Adult
• Auditory Brain Stem Implantation (methods)
• Auditory Brain Stem Implants
• Female
• Humans
• Male
• Middle Aged
• Neurofibromatosis 2 (complications, surgery)
• Neuroma, Acoustic (etiology, surgery)
• Retrospective Studies
• Tinnitus (etiology, surgery)