title: Acoustic neuroma observation associated with an increase in symptomatic tinnitus: results of the 2007-2008 Acoustic Neuroma Association survey.
abstract: OBJECTIVE
  Tinnitus is a known presenting symptom of acoustic neuromas, but little is known about the impact of observation or treatment on tinnitus. Most patients experience improvement with treatment, while others may worsen. Therefore, this study was designed to assess the overall impact of observation and treatment on tinnitus outcome in patients with acoustic tumors.
  
  
  METHODS
  Data from the 2007-2008 Acoustic Neuroma Association survey were used. Tinnitus severity was graded both at presentation and at last follow-up for all patients questioned. This data set was analyzed using the Student t-test and a linear regression model adjusted for possible confounders.
  
  
  RESULTS
  Overall there were more patients receiving intervention (n = 1138) for their acoustic neuromas than observation (n = 289). Presenting tumor size positively correlated with tinnitus severity score. Regardless of treatment (microsurgery or stereotactic radiosurgery), tinnitus improved at last follow-up and worsened in those who were observed (p = 0.02). When comparing microsurgical options, retrosigmoid and translabyrinthine resection improved tinnitus symptoms (both p < 0.01). Stereotactic radiosurgery had a treatment effect similar to microsurgery.
  
  
  CONCLUSIONS
  Presenting tinnitus severity correlates strongly with tumor size. Furthermore, regardless of treatment, there appears to be an overall reduction in tinnitus severity for all forms of microsurgery and stereotactic radiosurgery. Importantly, observation leads to a worsening in symptomatic tinnitus and therefore should be weighed in the treatment recommendation.
authors.affiliation: Departments of Neurosurgery and Brain Repair.
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Van Gompel
authors.forename: Jaymin
authors.initials: J
authors.lastname: Patel
authors.forename: Chris
authors.initials: C
authors.lastname: Danner
authors.forename: A Nanhua
authors.initials: AN
authors.lastname: Zhang
authors.forename: A A
authors.initials: AA
authors.lastname: Samy Youssef
authors.forename: Harry R
authors.initials: HR
authors.lastname: van Loveren
authors.forename: Siviero
authors.initials: S
authors.lastname: Agazzi
mesh_terms: D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D009464:Neuroma, Acoustic / Q000150:complications* / Q000601:surgery; D016634:Radiosurgery; D012720:Severity of Illness Index; D014012:Tinnitus / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome