J Neurol Surg B Skull Base 2020; 81(S 01): S1-S272
DOI: 10.1055/s-0040-1702463
Oral Presentations
Georg Thieme Verlag KG Stuttgart · New York

Cannot Stop, Will Not Stop: Assessing the Impact of Tinnitus on Patient-Reported Hearing-Related Quality-of-Life Outcomes in Vestibular Schwannoma

Avital Perry
1   Mayo Clinic, Rochester, Minnesota, United States
,
Christopher S. Graffeo
1   Mayo Clinic, Rochester, Minnesota, United States
,
Maria Peris-Celda
2   Albany Med, Albany, New York, United States
,
Lucas P. Carlstrom
1   Mayo Clinic, Rochester, Minnesota, United States
,
Geffen Kleinstern
1   Mayo Clinic, Rochester, Minnesota, United States
,
Matthew L. Carlson
1   Mayo Clinic, Rochester, Minnesota, United States
,
Michael J. Link
1   Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2020 (online)

 

Introduction: Tinnitus is the third most common presenting vestibular schwannoma (VS) symptom after hearing loss and headache. Although recognized as a prevalent contributor to lost quality-of-life (QOL) in VS, the relationship between tinnitus, hearing loss, and other hearing-related QOL outcomes remains incompletely characterized.

Methods: Prospective, observational, multicenter, multinational, and cross-sectional study, analyzed via multivariable linear and logistic regression.

Results: Total 422 VS patients with formal audiometry within 1 year of survey date were identified. Median age was 54 (range = 12–82) and 223 (53%) were females. Tinnitus was the primary presenting symptom in 34 of the 354 who recalled initial symptomatology (10%) and time-of-survey prevalence was 319 of 422 (76%). Among 34 patients presenting with tinnitus, it persisted in 32 at time of survey (OR: 6.5, 95% CI: 1.5–27.5).

After adjusting for age and sex, patients reporting tinnitus were significantly more likely to report subjective hearing loss (OR: 3.2; 95% CI: 1.8–5.9; p = 0.0001), as well as that concentration was affected by ringing, hissing, or other noises in their ears (OR: 7.2; 95% CI: 3.7–17.2; p < 0.0001). However, no significant differences were noted in subjective hearing loss severity, word recognition score, AAO-HNSF hearing class, ability to use the telephone in either ear, frequent hearing aid use in either ear, happiness with initial management strategy elected, or adverse impact on either personal relationships or conversations attributable to hearing loss. When patients with presenting, persistent tinnitus were compared with all patients without tinnitus at time-of-survey, none of the above-listed variables was significant.

Conclusion: Tinnitus may to confer a subjective impression of hearing loss that is neither captured by audiometric assessments nor associated with the same dramatic decline in quality-of-life associated with moderate-to-severe hearing loss. The QOL impact of tinnitus is predominantly limited to cognitive domains such as concentration, and appears to be significantly more pronounced in patients without tinnitus at presentation.