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High-frequency hearing, tinnitus, and patient satisfaction with stapedotomy: A randomized prospective study.

Bagger-Sjöbäck D, Strömbäck K, Hultcrantz M, Papatziamos G, Smeds H, Danckwardt-Lillieström N, Tideholm B, Johansson A, Hellström S, Hakizimana P, Fridberger A - Sci Rep (2015)

Bottom Line: Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation.These findings have practical importance for patients and their surgeons.Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Karolinska University Hospital, Stockholm, Sweden.

ABSTRACT
Otosclerosis is a common disorder that leads to conductive hearing loss. Most patients with otosclerosis also have tinnitus, and surgical treatment is known to improve hearing as well as tinnitus. Some patients however experience worsening of tinnitus after the operation, but there are no known factors that allow surgeons to predict who will be at risk. In this prospective observational study on 133 patients undergoing stapedotomy, we show that postoperative air conduction thresholds at very high stimulus frequencies predict improvement of tinnitus, as assessed with proportional odds logistic regression models. Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation. These findings have practical importance for patients and their surgeons. Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

No MeSH data available.


Related in: MedlinePlus

(a) Distribution of tinnitus scores before and after surgery. Dot sizes correspond to number of patients. Black horizontal lines denote the median values at each time point. (b) Proportional odds logistic regression models show how the probability of tinnitus becoming better depends on the average change in high frequency thresholds after surgery (black line). The probability of tinnitus becoming worse is plotted with the red line. Gray fields represent 95% confidence intervals. (c) Probability of tinnitus change at one year as a function of the average change in hearing thresholds across 10 to 14 kHz. (d) Relation between probability of tinnitus change and patient age at 6 weeks. (e) At one year, the probability of a change in tinnitus depends on age. (f,g) Patient satisfaction scores depend on the change in tinnitus scores at both 6 weeks and one year.
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f4: (a) Distribution of tinnitus scores before and after surgery. Dot sizes correspond to number of patients. Black horizontal lines denote the median values at each time point. (b) Proportional odds logistic regression models show how the probability of tinnitus becoming better depends on the average change in high frequency thresholds after surgery (black line). The probability of tinnitus becoming worse is plotted with the red line. Gray fields represent 95% confidence intervals. (c) Probability of tinnitus change at one year as a function of the average change in hearing thresholds across 10 to 14 kHz. (d) Relation between probability of tinnitus change and patient age at 6 weeks. (e) At one year, the probability of a change in tinnitus depends on age. (f,g) Patient satisfaction scores depend on the change in tinnitus scores at both 6 weeks and one year.

Mentions: Patients graded their tinnitus on a 10-grade scale, where zero corresponded to no tinnitus and 10 to very disturbing tinnitus. Before surgery, 68% of patients reported tinnitus (Fig. 4a). Improvement occurred in many patients and in the evening on the day of surgery, 53% had tinnitus. This percentage increased slightly at 6 weeks (58%) but then fell to 51% at one year. The increased number of patients without tinnitus translated into a 2-unit decrease in median scores (from 3 to 1 on the 10-grade scale; the corresponding mean scores were 3.4 ± 3.3 and 2.4 ± 2.9). This change, the magnitude of which remained stable throughout the observation period, was statistically significant (p < 0.001; Wilcoxon signed rank test).


High-frequency hearing, tinnitus, and patient satisfaction with stapedotomy: A randomized prospective study.

Bagger-Sjöbäck D, Strömbäck K, Hultcrantz M, Papatziamos G, Smeds H, Danckwardt-Lillieström N, Tideholm B, Johansson A, Hellström S, Hakizimana P, Fridberger A - Sci Rep (2015)

(a) Distribution of tinnitus scores before and after surgery. Dot sizes correspond to number of patients. Black horizontal lines denote the median values at each time point. (b) Proportional odds logistic regression models show how the probability of tinnitus becoming better depends on the average change in high frequency thresholds after surgery (black line). The probability of tinnitus becoming worse is plotted with the red line. Gray fields represent 95% confidence intervals. (c) Probability of tinnitus change at one year as a function of the average change in hearing thresholds across 10 to 14 kHz. (d) Relation between probability of tinnitus change and patient age at 6 weeks. (e) At one year, the probability of a change in tinnitus depends on age. (f,g) Patient satisfaction scores depend on the change in tinnitus scores at both 6 weeks and one year.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4544016&req=5

f4: (a) Distribution of tinnitus scores before and after surgery. Dot sizes correspond to number of patients. Black horizontal lines denote the median values at each time point. (b) Proportional odds logistic regression models show how the probability of tinnitus becoming better depends on the average change in high frequency thresholds after surgery (black line). The probability of tinnitus becoming worse is plotted with the red line. Gray fields represent 95% confidence intervals. (c) Probability of tinnitus change at one year as a function of the average change in hearing thresholds across 10 to 14 kHz. (d) Relation between probability of tinnitus change and patient age at 6 weeks. (e) At one year, the probability of a change in tinnitus depends on age. (f,g) Patient satisfaction scores depend on the change in tinnitus scores at both 6 weeks and one year.
Mentions: Patients graded their tinnitus on a 10-grade scale, where zero corresponded to no tinnitus and 10 to very disturbing tinnitus. Before surgery, 68% of patients reported tinnitus (Fig. 4a). Improvement occurred in many patients and in the evening on the day of surgery, 53% had tinnitus. This percentage increased slightly at 6 weeks (58%) but then fell to 51% at one year. The increased number of patients without tinnitus translated into a 2-unit decrease in median scores (from 3 to 1 on the 10-grade scale; the corresponding mean scores were 3.4 ± 3.3 and 2.4 ± 2.9). This change, the magnitude of which remained stable throughout the observation period, was statistically significant (p < 0.001; Wilcoxon signed rank test).

Bottom Line: Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation.These findings have practical importance for patients and their surgeons.Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Karolinska University Hospital, Stockholm, Sweden.

ABSTRACT
Otosclerosis is a common disorder that leads to conductive hearing loss. Most patients with otosclerosis also have tinnitus, and surgical treatment is known to improve hearing as well as tinnitus. Some patients however experience worsening of tinnitus after the operation, but there are no known factors that allow surgeons to predict who will be at risk. In this prospective observational study on 133 patients undergoing stapedotomy, we show that postoperative air conduction thresholds at very high stimulus frequencies predict improvement of tinnitus, as assessed with proportional odds logistic regression models. Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation. These findings have practical importance for patients and their surgeons. Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

No MeSH data available.


Related in: MedlinePlus