House J W, Brackmann D E
Ciba Found Symp. 1981;85:204-16. doi: 10.1002/9780470720677.ch12.
Surgical treatment of tinnitus includes destructive procedures, neurectomies, stapedectomies and tympanosympathectomies. Translabyrinthine procedures for the removal of acoustic neuromas and sectioning of the eighth nerve to eliminate vertigo are analogous to cutting the eighth nerve as a surgical intervention for tinnitus. After surgical removal of acoustic tumours with excision of the auditory nerve in 414 patients, only 40% reported improvement in their tinnitus. Of 68 patients undergoing translabyrinthine eighth nerve section, 60 (80%) had tinnitus preoperatively. Improvement occurred in 45%, while 55% reported the condition to be the same or worse. In patients undergoing middle cranial fossa section of the vestibular nerve for vertigo or dizziness, most reported the tinnitus to be the same but a significant number felt that it was worse. Stapedectomy improves hearing in most patients but improves the symptom of tinnitus in only about half of the patients. Cochlear implant patients report an improvement in their tinnitus with use of the stimulator and implant. Implant procedures might therefore be used in patients who suffer from severe tinnitus. Surgical management of tinnitus, although successful in some cases, does not provide a valid and reliable mode of treatment for subjective tinnitus.
耳鸣的外科治疗包括破坏性手术、神经切除术、镫骨切除术和鼓室交感神经切除术。经迷路手术切除听神经瘤并切断第八对脑神经以消除眩晕，类似于切断第八对脑神经作为耳鸣的一种外科干预手段。在414例患者手术切除听神经瘤并切除听神经后，只有40%的患者报告耳鸣有所改善。在68例行经迷路第八对脑神经切断术的患者中，60例（80%）术前有耳鸣。45%的患者症状有所改善，而55%的患者报告病情未变或恶化。在前庭神经中颅窝切断术治疗眩晕或头晕的患者中，大多数患者报告耳鸣情况未变，但有相当一部分患者感觉耳鸣加重。镫骨切除术能使大多数患者听力改善，但仅约一半患者的耳鸣症状得到改善。人工耳蜗植入患者报告使用刺激器和植入物后耳鸣有所改善。因此，植入手术可用于严重耳鸣患者。耳鸣的外科治疗虽然在某些情况下取得成功，但对于主观性耳鸣而言，并非一种有效且可靠的治疗方式。
