College of Medicine, University of Vermont, Burlington, Vermont.
Departments of 1 Neurological Surgery and.
J Neurosurg. 2017 Apr;126(4):1148-1157. doi: 10.3171/2016.2.JNS152913. Epub 2016 May 20.
OBJECTIVE The objective of this study was to examine operative outcomes in cases of microvascular decompression (MVD) of cranial nerve (CN) VIII for tinnitus through a critical review of the literature. METHODS Forty-three English-language articles were gathered from PubMed and analyzed. In this review, two different case types were distinguished: 1) tinnitus-only symptomatology, which was defined as a patient with tinnitus with or without sensorineural hearing loss; and 2) mixed symptomatology, which was defined as tinnitus with symptoms of other CN dysfunction. This review reports outcomes of those with tinnitus-only symptoms. RESULTS Forty-three tinnitus-only cases were found in the literature with a 60% positive outcome rate following MVD. Analysis revealed a 5-year cutoff of preoperative symptom duration before which a good outcome can be predicted with 78.6% sensitivity, and after which a poor outcome can be predicted with 80% specificity. CONCLUSIONS As the 60% success rate is more promising than several other therapeutic options open to the chronic tinnitus sufferer, future research into this field is warranted.
通过文献回顾,研究分析微血管减压术(MVD)治疗耳鸣的手术效果。
从 PubMed 数据库中收集了 43 篇英文文献进行分析。本研究将两种不同的病例类型进行区分:1)仅有耳鸣症状,定义为耳鸣伴或不伴感音神经性听力损失的患者;2)混合症状,定义为耳鸣伴其他颅神经功能障碍的症状。本综述报告了仅有耳鸣症状患者的治疗结果。
文献中发现 43 例仅有耳鸣症状的患者,术后 60%的患者耳鸣症状得到改善。分析显示,术前症状持续时间的 5 年截止时间,在此之前可以预测良好的结果,敏感性为 78.6%,在此之后可以预测较差的结果,特异性为 80%。
与慢性耳鸣患者可选择的其他几种治疗方法相比,60%的成功率更有希望,因此该领域的未来研究是有必要的。