Pulsatile tinnitus in patients with morbid obesity: the effectiveness of weight reduction surgery.
BACKGROUND
Morbid obesity is increasing in the United States population. Morbidly obese patients may have disabling pulsatile tinnitus (PT) secondary to pseudotumor cerebri syndrome and often seek treatment from otolaryngologists because of this symptom.


OBJECTIVE
To determine the effectiveness of weight reduction surgery (WRS) for relief of PT in patients with morbid obesity.


METHODS
Retrospective study of morbidly obese patients with associated PT.


METHODS
Academic tertiary referral center.


METHODS
Sixteen women with morbid obesity and associated PT who underwent WRS.


RESULTS
Median age was 34 years (range 24-45 years). Average preoperative body mass index was 45 kg/m2 (range 33-70 kg/m2). Average weight loss was 45+/-17 kg (range 25-99 kg). Average postoperative weight was 75+/-14 kg (range 57-105 kg). The average preoperative cerebrospinal fluid pressure was 344+/-103 mm H2O (range 220-520 mm H2O). Postoperative measurements of cerebrospinal fluid, obtained on 4 patients, revealed an average decrease in pressure of 198 mm H2O (range 120-400 mm H2O). Thirteen patients experienced complete resolution of their PT (81%). Three patients continued to have PT despite significant weight reduction.


CONCLUSIONS
Weight reduction surgery was effective in relieving PT in morbidly obese patients with associated pseudotumor cerebri syndrome and should be considered when conservative management has failed.
Michaelides
E M
EM
Department of Otolaryngology/Head Neck Surgery, Medical College of Virginia of Virginia Commonwealth University, Richmond 23298, USA.
Sismanis
A
A
Sugerman
H J
HJ
Felton
W L
WL
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D011559:Pseudotumor Cerebri / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies; D014012:Tinnitus / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome; D015431:Weight Loss