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

BACKGROUND

Morbid obesity is increasing in the United States population. Morbidly obese patients may have disabling pulsatile tinnitus (PT) secondary to pseudotumor cerebri syndrome and often seek treatment from otolaryngologists 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 associated 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 24-45 years). Average preoperative body mass index was 45 kg/m2 (range 33-70 kg/m2). Average weight loss was 45+/-17 kg (range 25-99 kg). Average postoperative weight was 75+/-14 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 decrease in pressure of 198 mm H2O (range 120-400 mm H2O). Thirteen patients experienced complete resolution of their PT (81%). Three patients continued to have PT despite significant weight reduction.

CONCLUSIONS

Weight reduction surgery was effective in relieving PT in morbidly obese patients with associated pseudotumor cerebri syndrome and should be considered when conservative management has failed.