Semin Hear 2001; 22(1): 077-088
DOI: 10.1055/s-2001-13022
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Tinnitus and Vestibular Schwannoma

David M. Baguley1 , Phillip Chang2 , David A. Moffat2
  • 1Department of Audiology, Addenbrooke's Hospital, Cambridge, United Kingdom
  • 2Neuro-Otology Department, Addenbrooke's Hospital, Cambridge, United Kingdom. Dr. Chang is now at House Ear Insititute, Los Angeles, California
Further Information

Publication History

Publication Date:
31 December 2001 (online)

ABSTRACT

The heterogeneity within the population of patients with a complaint of tinnitus is high, and this has been a limiting factor in research and the development of effective treatments. With this in mind, the present article reviews published information about experiences of tinnitus in patients diagnosed with a vestibular schwannoma. This provides a relatively homogenous group. The incidence of tinnitus pre-operatively in this condition is described as over 70%, and mechanisms for tinnitus generation are considered. The use of magnetic resonance imaging (MRI) to exclude vestibular schwannoma in a tinnitus clinic context is advocated, with a caveat on potential discomfort caused by scanner noise. The incidence of tinnitus after surgical excision of vestibular schwannoma is described, and models of tinnitus persistence and predictive factors are considered. Treatment options are described and, in particular, the use of transcranial CROS hearing aid strategies are suggested.

REFERENCES

  • 1 Jackler R K. Acoustic neuroma. In: Jackler RK, Brackmann D, eds. Neurotology St. Louis, MO: Mosby 1994: 729-785
  • 2 Brackmann D E, Syms C A. Tumors of the auditory-vestibular nerve. In: Ludman H, Wright T, eds. Diseases of the Ear, 6th ed London: Arnold 1998: 533-547
  • 3 Clemis J D, Ballad W J, Baggot P J, Lyon S T. Relative frequency of inferior vestibular schwannoma.  Arch Otolaryngol Head Neck Surg . 1986;  112 190-194
  • 4 Ludman C N, O'Donoghue G M. Magnetic resonance imaging demonstrating the origin of a vestibular schwannoma to be the superior division of the vestibular nerve.  Am J Otol . 2000;  21 135-136
  • 5 Hardy M, Crowe S J. Early asymptomatic acoustic tumor. Report of six cases.  Arch Surg . 1936;  32 292-301
  • 6 Leonard J R, Talbot M L. Asymptomatic acoustic neurilemmoma.  Arch Otolaryngol . 1970;  91 117-124
  • 7 Moffat D A, Hardy D G, Irving R M. Referral patterns in vestibular schwannomas.  Clin-Otolaryngol . 1995;  20 80-83
  • 8 Tos M, Charabi S, Thomsen J. Incidence of vestibular schwannomas.  Laryngoscope . 1999;  109 736-740
  • 9 Charabi S, Thomsen J, Tos M. Acoustic neuroma/vestibular schwannoma growth: past, present and future.  Acta Otolaryngol (Stockh) . 1998;  118 327-332
  • 10 Walsh R M, Bath A P, Bance M L. The role of conservative management of vestibular schwannomas.  Clin Otolaryngol . 2000;  25 28-39
  • 11 Mirz F, Jorgensen B, Fiirgaard B, Lundorf E, Pedersen C B. Investigations into the natural history of vestibular schwannomas.  Clinical Otolaryngol . 1999;  24 13-18
  • 12 Prasad D, Steiner M, Steiner L. Gamma surgery for vestibular schwannoma.  J Neurosurg . 2000;  92 745-759
  • 13 Moffat D A, Baguley D M, Beynon G J, Da Cruz M. Clinical acumen and vestibular schwannoma.  Am J Otol . 1998;  19 82-87
  • 14 Moller A R. Pathophysiology of tinnitus.  Ann Otol . 1984;  93 39-44
  • 15 Eggermont J J. On the pathophysiology of tinnitus: a review and peripheral model.  Hearing Research . 1990;  48 111-124
  • 16 Levine R A, Kiang N YS. A conversation about tinnitus. In:Vernon JA, Moller AR,eds. Mechanisms of Tinnitus.  London: Allyn & Bacon; 1995
  • 17 Baguley D M. Neurophysiological approach to tinnitus patients.  American J Otology . 1997;  18 265 (Letter to the Editor)
  • 18 Jastreboff P J. Tinnitus. In: Gates G, ed. Current Therapy in Otolaryngology-Head and Neck Surgery St Louis, MO: Mosby 1998: 90-95
  • 19 Collins J J, Shaw C C, Inhoff T T. Stochastic resonance without tuning.  Nature . 1995;  376 236-238
  • 20 Ferguson M A, O'Donoghue G M, Aitcheson Y, McConnachie N M, Diamantopoulos I. Radiological correlates of auditory function in patients with cerebellopontine angle tumors. Proceedings of the Third International Conference on Acoustic Neuroma (in press)
  • 21 Sahley T L, Nodar R H, Musiek F E. Efferent Auditory System: structure and function.  San Diego, CA: Singular; 1997
  • 22 Hazell J WP. Assessment and psychoacoustical aspects of tinnitus. In: Ludman, Wright T, eds. Diseases of the Ear, 6th ed London: Arnold 1998: 196-202
  • 23 Wilson D F, Talbot M, Mills L. A critical appraisal of the role of auditory brain stem response and magnetic resonance imaging in acoustic neuroma diagnosis.  Am J Otol . 1997;  18 673-681
  • 24 Selesnick S H, Jackler R K, Pitts L W. The changing clinical presentation of acoustic tumors in the MRI era.  Laryngoscope . 1993;  103 431-436
  • 25 van Leeuwen J P M P, Harhangi B S, Thewissen N M W P, Thijssen H OM, Cremers C R J W. Delays in the diagnosis of acoustic neuromas.  Am J Otology . 1996;  17 321-325
  • 26 Dawes P JD, Basiouny H E. Outcome of using magnetic resonance imaging as an initial screen to exclude vestibular schwannoma in patients presenting with unilateral tinnitus.  J Laryngol Otol . 1999;  113 818-822
  • 27 Moffat D A, Hardy D G, Baguley D M. Strategy and benefits of acoustic neuroma searching.  JLO . 1989;  103 51-59
  • 28 Bance M L, Hyde M L, Malizia K. Decision and cost analysis in acoustic neuroma diagnosis.  J Otolaryngol . 1994;  23 109-20
  • 29 Harcourt J P, Vijaya-Sekaran S, Loney E, Lennox P. The incidence of symptoms consistent with cerebello-pontine angle lesions in a general ENT out-patient clinic.  J Laryngol Otol . 1999;  113 518-522
  • 30 Foster J R, Hall D A, Sumeerfield A Q, Palmer A R, Bowtell R W. Sound-level measurements and calculations of safe noise dosage during EPI at 3 T.  J Mag Reson Imaging . 2000;  12 157-163
  • 31 Baguley D M, Moffat D A, Hardy D G. What is the effect of translabyrinthine acoustic schwannoma removal upon tinnitus?.  J Laryng Otol . 1992;  106 329-331
  • 32 Andersson G, Kinnefors A, Ekvall L, Rask-Andersen H. Tinnitus and translabyrinthine acoustic neuroma surgery.  Audiology and Neuro-otology . 1997;  2 403-409
  • 33 Catalano P J, Post K D. Elimination of tinnitus following hearing preservation surgery for acoustic neuromas.  Am J Otol . 1996;  17 443-445
  • 34 Kanzaki J, Satoh A, Kunihiro T. Does hearing preservation surgery for acoustic neuromas affect tinnitus?.  Skull Base Surgery . 1999;  9 169-176
  • 35 Seltzer Z, Devor M. Ephaptic transmission in chronically damaged peripheral nerves.  Neurology . 1979;  29 1061-1064
  • 36 House J W, Brackmann D E. Tinnitus: surgical treatment. In: Evered D, Lawrenson G, eds. Tinnitus Ciba Foundation Symposium 85, Ciba Foundation; 1981: 204-216
  • 37 Gardener G. Neurologic surgery and tinnitus.  Laryngol Otol . 1984;  9 311-318
  • 38 Silverstein H, Haberkamp T, Smouha E. The state of tinnitus after inner ear surgery.  Am J Otol . 1986;  95 438-441
  • 39 Berliner K I, Shelton C, Hitselberger W E, Luxford W M. Acoustic tumors: effect of surgical removal on tinnitus.  Am J Otol . 1992;  12 13-17
  • 40 Parving A, Tos M, Thomsen J, Moller H, Buchwald C. Some aspects of life quality after surgery for acoustic neuroma.  Arch Otolaryngol Head Neck Surg . 1992;  118 1061-1064
  • 41 Henrich D E, McCabe B F, Gantz B J. Tinnitus and acoustic neuromas: analysis of the effect of surgical excision on postoperative tinnitus.  ENT J . 1995;  74 462-466
  • 42 Weigand D A, Ojemann R G, Fickel V. Surgical treatment of acoustic neuroma (vestibular schwannoma) in the United States: report from the acoustic neuroma registry.  Laryngoscope . 1996;  106 58-66
  • 43 Harcourt J, Thomsen J, Tos M. Translabyrinthine vestibular schwannoma surgery: postoperative tinnitus and cochlear nerve integrity.  Auris Nasus Larynx . 1997;  24 21-26
  • 44 Rigby P L, Shah S B, Jackler R K, Chung J H, Cooke D D. Acoustic neuroma surgery: outcome analysis of patient-perceived disability.  Am J Otol . 1997;  18 427-435
  • 45 Bateman N, Nikolopoulos T P, Robinson K, O' Donoghue G M. Impairments, disabilities and handicaps after acoustic neuroma surgery.  Clin Otolaryngol . 2000;  25 62-65
  • 46 Newman C W, Jacobson G P, Spitzer J B. Development of the tinnitus handicap inventory.  Arch Otolaryngol Head Neck Surg . 1996;  122 143-148
  • 47 Newman C W, Sandridge S A, Jacobson. Psychometric adequacy of the Tinnitus Handicap Inventory ( THI ) for evaluating treatment outcome.  J Am Acad Audiol . 1998;  9 153-160
  • 48 Wall M, Rosenberg M, Richardson D. Gaze-evoked tinnitus.  Neurology . 1987;  37 1034-1036
  • 49 Cacace A T, Lovely T J, Winter D F, Parnes S M, McFarland D J. Auditory perceptual and visual-spatial characteristics of gaze-evoked tinnitus.  Audiology . 1994;  33 291-303
  • 50 Cacace A T, Lovely T J, McFarland D J, Parnes S M, Winter D F. Anomalous cross-modal plasticity following posterior fossa surgery: some speculations on gaze-evoked tinnitus.  Hear Res . 1994;  81 22-32
  • 51 Lockwood A H, Salvi R J, Coad M L. The functional neuroanatomy of tinnitus: evidence for limbic system links and neural plasticity.  Neurology . 1998;  50 114-120
  • 52 Lockwood R J, Burkard R F, Salvi R J. Positron emission tomographic studies (PET) of gaze evoked tinnitus. Association for Research in Otolaryngology, Feb 1999 (Abstract)
  • 53 Moffat D A, Baguley D M, Beynon G J, Stoddard R L, Hardy D G. Audio-vestibular handicap measures after acoustic neuroma surgery. Third International Conference on Acoustic Neuroma, Rome, June 1999 (Abstract)
  • 54 Rigby P L, Shah S B, Jackler R K, Chung J H, Cooke D D. Acoustic neuroma surgery: outcome analysis of patient-perceived diasability.  Am J Otol . 1997;  18 427-435
  • 55 Riley A, Aitcheson Y. Reported benefits from the use of CROS hearing aids following acoustic neuroma surgery. British Society of Audiology Short Papers meeting, March 1999 (Abstract)
  • 56 Sullivan R F. Transcranial ITE CROS.  Hearing Instruments . 1988;  39 11-12
  • 57 Hayes D E, Chen J M. Bone-conduction amplification with completely-in-the-canal hearing aids.  J Am Acad Audiol . 1998;  9 59-66
  • 58 Jastreboff P J, Jastreboff M. Tinnitus retraining therapy.  J Am Acad Audiol . 2000;  11 162-177