VASCULAR DECOMPRESSION SURGERY FOR SEVERE TINNITUS - SELECTION CRITERIA AND RESULTS

Seventy-four patients were operated on within a period of 10 years to treat incapacitating tinnitus; 72 underwent microvascular decompressio n (MVD) of the intracranial portion of the auditory nerve, and 2 under went section of the eighth nerve close to the brain stem. Of those who underwent MVD, 2 had no change in symptoms and later also underwent s ection of the eighth nerve near the brain stem. Two patients did not r eturn for follow-up. Of the 72 remaining patients, 13 (18.1%) experien ced total relief from tinnitus, 16 (22.2%) showed marked improvement, 8 (11.1%) showed slight improvement, 33 (45.8%) had no improvement, an d 2 (2.8%) became worse. The patients who experienced total relief and those who showed marked improvement had experienced their tinnitus fo r an average of 2.9 years and 2.7 years, respectively; those who showe d slight improvement and those who had no improvement had experienced their tinnitus for a longer time before the operation (mean, 5.2 and 7 .9 years, respectively). Of the 72 patients who were operated on and f ollowed, 32 were women. Of these, 54.8% experienced total relief from tinnitus or marked improvement, while only 29.3% of the men showed suc h relief or improvement. Selection of the patients for operation was m ainly based on patient history and, to some extent, on auditory test r esults (brainstem auditory evoked potentials [BAEP], acoustic middle e ar reflexes, and audiometric data).