An Investigation of the Effect of Structured Teaching on a Group of Tinnitus Patients After Vestibular Schwannoma Removal

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Abstract

Objective: This study aimed to determine the effect of a structured lecture and discussion on the tinnitus handicap and tinnitus intensity experienced by a group of patients who had undergone surgical removal of a unilateral vestibular schwannoma.

Study Design: The study design was a prospective repeated measures trial.

Setting: The study was conducted on a support group for patients with vestibular schwannoma based on a University Hospital Department of Neuro-Otology.

Patients: Twenty-one members of a vestibular schwannoma support group who attended a meeting entitled, “Living with Tinnitus” participated. All patients had undergone a surgical removal of a nuilateral sporadic vestibular schwannoma.

Intervention: A structured lecture and a discussion on the nature of tinnitus and how to live with it by an audiological scientist was performed.

Main Outcome Measures: Score on the tinnitus handicap inventory (THI) and associated functional, emotional, and catastrophic subscales and a visual analog scale (VAS) rating of tinnitus intensity were measured. Both measures were taken before intervention and 6 months after intervention. All measures were self-administered.

Results: Of 21 patients attending the lecture, 19 completed both preintervention and postintervention measures. Mean age was 58 years (range, 35–74 years). No significant difference was seen between pre-THI and post-THI total score, subscale scores, or VAS score. NO correlation between THI score, VAS score, age, and length of postoperative period was seen. Although preintervention THI and VAS scores were not significantly correlated, there was a significant correlation between THI total and VAS score after intervention and THI functional subscale and VAS score after intervention. The study group was compared with the validation group for THI: significant differences were seen between sample postintervention emotional score and validation emotional score and between sample catastrophic scores and validation catastrophic score. In each case, the sample scores were lower (less handicap) than the validation scores.

Conclusions: This intervention did not make a significant difference to the THI score of the sample group. The fact that the sample group had significantly different tinnitus handicap than the validation group is of note and indicative that postoperative tinnitus in patients with vestibular schwannoma does not lead to as great an emotional and catastrophic handicap as in a general tinnitus group.

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