An investigation of the effect of structured teaching on a group of tinnitus patients after vestibular schwannoma removal

Objective: This study aimed to determine the effect of a structured lecture and discussion on the tinnitus handicap and tinnitus intensity experienced by a group of patients who had undergone surgical removal of a unilateral vestibular schwannoma. Study Design: The study design was a prospective repeated measures trial. Setting: The study was conducted on a support group for patients with vesti bular schwannoma based on a University Hospital Department of Neuro-Otology . Patients: Twenty-one members of a vestibular schwannoma support group who a ttended a meeting entitled, "Living with Tinnitus" participated. All patien ts bad undergone a surgical removal of a unilateral sporadic vestibular sch wannoma. Intervention: A structured lecture and a discussion on the nature of tinnit us and how to live with it by an audiological scientist was performed. Main Outcome Measures: Score on the tinnitus handicap inventory (THI) and a ssociated functional, emotional, and catastrophic subscales and a visual an alog scale (VAS) rating of tinnitus intensity were measured. Both measures were taken before intervention and 6 months after intervention. All measure s were self-administered. Results: Of 21 patients: attending the lecture. 19 completed both preinterv ention and postintervention measures. Mean age was 58 years (range, 35-74 y ears). No significant difference was seen between pre-THI and post-THI tota l score, subscale scores, or VAS score. No correlation between THI score, V AS score. age, and length of postoperative period was seen. Although preint ervention THI and VAS scores were not significantly correlated, there was a significant correlation between Till total and VAS score after interventio n and THI functional subscale and VAS score after intervention. The study g roup was compared with the validation group for Tl-ll. significant differen ces were seen between sample postintervention emotional score and validatio n emotional score and between sample catastrophic scores and validation cat astrophic score. In each case, the sample scores were lower (less handicap) than the validation scores. Conclusions: This intervention did not make a significant difference to the Till score of the sample group. The fact that the sample group had signifi cantly different tinnitus handicap than the validation group is of note and indicative that post operative tinnitus in patients with vestibular schwan noma does not lead to as great an emotional and catastrophic handicap as in a general tinnitus group.