Microvascular decompression for tinnitus: surgical indication with median nerve stimulation

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Microvascular decompression for tinnitus by neurovascular compression can improve tinnitus; however, surgical indications remain controversial. We report the results of an analysis of the symptoms of surgical patients who were categorized on the basis of modulation by the median nerve. We also analyzed changes in tinnitus intensity using the pitch-match loudness method in 35 patients with tinnitus. Three significant (P < 0.001) changes were observed with increases in the intensity on the median nerve: no change (N-type), suppression (S-type), and excitation (E-type). We evaluated 16 patients (16 sides) who underwent preoperative modulation tests and 10 patients (10 sides) who did not (F-type). Four patients who had S- or N-type tinnitus intensity (25%) had tinnitus-free sides; all had experienced tinnitus for 6 years or less and an improvement in tinnitus was observed in 8/16 sides (50%). Good results (the complete resolution of tinnitus or improvements in tinnitus without high-pitched tin- nitus) were observed in 6/7 sides (86%) in S-type patients. More patients in the S-type group had good outcomes following median nerve stimulation than those in the other groups. We conclude that patients with S-type tinnitus for 6 years or less are good candidates for surgery and may show good indications.
Yamaguchi University School of Medicineの論文