Pulsatile tinnitus in patients with morbid obesity: The effectiveness of weight reduction surgery

Background: Morbid obesity is increasing in the United States population. M orbidly obese patients may have disabling pulsatile tinnitus (PT) secondary to pseudotumor cerebri syndrome and often seek treatment from otolaryngolo gists because of this symptom. Objective: To determine the effectiveness of weight reduction surgery (WRS) for relief of PT in patients with morbid obesity. Study Design: Retrospective study of morbidly obese patients with associate d PT. Setting: Academic tertiary referral center. Patients: Sixteen women with morbid obesity and associated PT who underwent WRS. Results: Median age was 34 years (range 24-15 years). Average preoperative body mass index was 45 kg/mL (range 33-70 kg/m(2)). Average weight loss was 45 +/- 17 kg (range 25-99 kg). Average postoperative weight was 75 +/- 13 kg (range 57-105 kg). The average preoperative cerebrospinal fluid pressure was 344 +/- 103 mm H2O (range 220-520 mm H2O). Postoperative measurements of cerebrospinal fluid, obtained on 4 patients, revealed an average decreas e in pressure of 198 mm B2O (range 120-400 mm H2O). Thirteen patients exper ienced complete resolution of their PT (81%). Three patients continued to h ave PT despite significant weight reduction. Conclusions: Weight reduction surgery was effective in relieving PT in morb idly obese patients with associated pseudotumor cerebri syndrome and should be considered when conservative management has failed.