title: Willingness-to-accept Gamma knife radiosurgery for tinnitus among career San Francisco firefighters.
abstract: OBJECTIVE
  Measure willingness-to-accept novel Gamma knife (GK) radiosurgery of the caudate nucleus to treat tinnitus among career firefighters who are at higher risk of hearing loss because of occupational noise exposure.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A Web-based 80-item survey was distributed to 800 San Francisco firefighters and satisfactorily completed by 101 respondents. Demographic and work-related characteristics including occupational noise exposure, hearing handicap using the Hearing Handicap Inventory for Adults (HHIA), and tinnitus severity using the tinnitus functional index (TFI) were assessed. Willingness-to-accept GK radiosurgery for tinnitus was profiled using a 7-point scale for 6 decremental levels of expected tinnitus improvement.
  
  
  RESULTS
  Respondents were a majority male (82%) and Caucasian (56%). Nearly all (95%) reported significant daily or weekly occupational noise exposure. Mean HHIA (16.3) and mean TFI (14.6) were mild. At the 100% (complete) tinnitus improvement level, more than 60% of respondents were "likely" willing-to-accept Gamma knife radiosurgery. At the 75% tinnitus improvement level, 43% of respondents were "likely" willing-to-accept GK radiosurgery. Below the 75% tinnitus improvement level, willingness-to-accept dropped off steeply.
  
  
  CONCLUSIONS
  Gamma knife radiosurgery to area LC, a locus of the caudate nucleus, for tinnitus would be of interest to a large population with moderate or lower tinnitus distress. Should this innovative intervention be considered in the future, a rigorous clinical trial will be necessary to establish safety and efficacy.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery, and †Department of Community Health Systems, University of California, San Francisco, California, U.S.A.
authors.forename: Seth E
authors.initials: SE
authors.lastname: Pross
authors.forename: Camille A
authors.initials: CA
authors.lastname: Allen
authors.forename: Oi Saeng
authors.initials: OS
authors.lastname: Hong
authors.forename: Steven W
authors.initials: SW
authors.lastname: Cheung
mesh_terms: D000328:Adult; D002421:Caudate Nucleus / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D061388:Firefighters / Q000523:psychology*; D034381:Hearing Loss / Q000523:psychology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D016634:Radiosurgery / Q000523:psychology*; D012044:Regression Analysis; D012495:San Francisco; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000523:psychology* / Q000601:surgery*