Tinnitus and Vestibular Schwannoma

Vestibular schwannomas (VS) are associated with ipsilateral hearing loss (95%), tinnitus (70–80%), and disorders of balance (50%). However, unilateral hearing loss does not equate to a vestibular schwannoma. When an MRI scan is performed for unilateral hearing loss, in only 0.3% of patients, a VS is identified. Tinnitus is the principal symptom in 10% of VS patients, usually in very small or very large tumors, and is moderate to severe in 14% of individuals. It is mostly of high pitch. Tinnitus improves when the cochlear nerve is transected, or hearing is saved during treatment. In general, microsurgery has better outcomes for tinnitus than stereotactic radiosurgery (SRS). This is likely related to the fact that after retrosigmoid and translabyrinthine, microsurgery tinnitus is often experienced as less troublesome than before the surgery.