Surgery for Tinnitus
November 13, 2020

Tinnitus is a condition that causes people to hear sounds that aren't actually present. It can manifest as anything from ringing in the ears to hissing or clicking. There is no reliable cure for Tinnitus, but many treatments are available. One of those is surgery. Though surgery is not considered a useful means of treating most forms of Tinnitus, it can help decrease the symptoms dramatically. 

Is Surgery A Treatment Option For Tinnitus?

Diagram of the human brain and ear in relation to surgery for tinnitus

Unfortunately, Tinnitus remains very difficult to treat. Since it is mostly a condition reported by patients rather than one observed, doctors often struggle to get a handle on it. This also means that surgical intervention is only successful in certain instances. 

Tinnitus is usually a symptom of another disorder or sickness. The conditions that accompany the emergence of the symptom vary widely. The context in which Tinnitus develops also has a significant influence on the viability of surgical intervention options. 

To find out if surgery is a viable option for treating your case of Tinnitus, the first thing you need to do is have a physician diagnose your specific hearing condition. 

Tinnitus comes in two primary forms. Objective Tinnitus is a condition where the noise bothering the patient can be observed by medical staff, and Subjective Tinnitus cannot be observed through any diagnostic means. The different types may also react to surgery differently.

After diagnosis, your doctor should try to locate the root cause of your Tinnitus. Once those factors have been established, you may discover that surgery is a viable option.

Does Pulsatile Tinnitus Need Surgery?

Doctor looking at Xray of skull preparing for tinnitus surgery

One rarer form of objective tinnitus is pulsatile tinnitus. Patients who are hearing a steady beat, rather than just random noise, may be suffering from this condition. When it appears in this form, the noise emanates from the body as well. This can be very annoying or even unbearable to the patient. However, a traceable sound allows the doctor to trace the problem to a specific cause. Some of these causes can include irregularities in the blood vessels. 

Thrombectomy surgery can be remarkably successful in these instances. In these procedures, the surgeon cuts into the blood vessel and removes the relevant obstruction. If the irregular blood vessel was indeed the cause of the offending noise, the symptoms should soon cease completely. 

There are also less invasive procedures for the treatment of pulsatile Tinnitus. Some cases are caused by venous sinus stenosis, which affects the veins in the brain. A treatment involving stenting the narrowed veins is now in a promising clinical trial and is worth keeping an eye on. 

If successful, the treatment will alleviate the obstruction to blood flow in the area and drastically reduce tinnitus. A patient undergoing this procedure can expect to be hospitalized for only 1-2 days. 

Tinnitus Caused by Tumors and Cysts

Diagram of tumors or cysts which may cause tinnitus

In some cases, the noise can be caused by a cyst or tumor pinching on the auditory nerve. When Tinnitus appears under these circumstances, there is a physically removable source. Not surprisingly, these instances are most conducive to successful surgery. 

One of the most commonly performed tinnitus-related surgeries involves the removal of acoustic tumors (vestibular schwannoma). These are non-cancerous tumors that can develop on the main nerve connecting the brain to the inner ear. Though this is one of the most straightforward surgeries related to Tinnitus, it only improves the malady in 40% of the cases. 

Another promising procedure for tinnitus caused by tumors is the use of surgical cochlear nerve decompression. In this type of surgery, a portion of the bone or disk material near the nerve root is removed to provide more space. Though controversial, one study shows that the procedure has a 52% success rate in reducing long-term symptoms in relevant cases.

What Should I Do If I Think I Have Tinnitus?

The disparity in outcomes and the complexity of treating tinnitus emphasizes the importance of receiving first-rate medical opinions on the matter. Always consult with a trusted physician before taking any measures to deal with your condition, especially if you’re considering invasive surgery. It is always worth it to get a second opinion.

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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