Silverstein H, Haberkamp T, Smouha E
Otolaryngol Head Neck Surg. 1986 Nov;95(4):438-41. doi: 10.1177/019459988609500404.
A retrospective study of several procedures--for either treatment of vertigo or resection of acoustic neuromas--was performed to determine their effect on tinnitus. Subjective ratings of the state of tinnitus (resolution, improvement, maintenance, or deterioration) were obtained by questionnaire. Surgical procedures performed for correction of vertigo frequently alter tinnitus. In general, procedures that conserve hearing--namely, retrolabyrinthine vestibular neurectomy (RVN), middle fossa vestibular neurectomy (MFVN), and endolymphatic shunt procedures (ELS)--have a 50% to 65% chance of helping relieve tinnitus and up to a 22% chance of worsening tinnitus. When there is no serviceable hearing, cochleovestibular neurectomy (CVN) offers the best cure rate for tinnitus (76%) and the least chance of worsening tinnitus (3%). When hearing is minimal and the patient complains of tinnitus, a CVN--rather than a labyrinthectomy--should be recommended. However, when useful hearing is present, a CVN is not usually recommended for relief of tinnitus, since the actual cure rates are only 35%. When vertigo is not a complaint, there is currently no surgical procedure known that can be recommended for the treatment of tinnitus.
我们进行了一项回顾性研究，涉及多种治疗眩晕或切除听神经瘤的手术，以确定其对耳鸣的影响。通过问卷调查获得了对耳鸣状态（缓解、改善、维持或恶化）的主观评分。为纠正眩晕而进行的外科手术常常会改变耳鸣状况。一般来说，保留听力的手术——即迷路后前庭神经切除术（RVN）、中颅窝前庭神经切除术（MFVN）和内淋巴分流术（ELS）——有50%至65%的几率有助于缓解耳鸣，高达22%的几率会使耳鸣恶化。当没有可用听力时，耳蜗前庭神经切除术（CVN）对耳鸣的治愈率最高（76%），使耳鸣恶化的几率最小（3%）。当听力微弱且患者抱怨耳鸣时，应推荐进行CVN而非迷路切除术。然而，当存在有用听力时，通常不推荐进行CVN来缓解耳鸣，因为实际治愈率仅为35%。当患者没有眩晕症状时，目前尚无已知的可推荐用于治疗耳鸣的外科手术。
