gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Impairment of quality of life by tinnitus and vertigo after microsurgery in the cerebellopontine angle

Einschränkung der Lebensqualität durch Tinnitus und Vertigo nach mikrochirurgischen Operationen im Kleinhirnbrückenwinkel

Meeting Abstract

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  • corresponding author J. Grauvogel - Abteilung für Allgemeine Neurochirurgie, Universitätsklinikum Freiburg
  • S. K. Rosahl - Klinik für Neurochirurgie, Helios Klinikum Erfurt

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 105

The electronic version of this article is the complete one and can be found online at:

Published: April 11, 2007

© 2007 Grauvogel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: There is often a disagreement between the clinical assessment of success by the surgeon and the subjective well-being of the patient after tumour surgery in the cerebellopontine angle and in the internal auditory canal (IAC). Tinnitus and vertigo are important factors in this context which may impede the patient's quality of life despite complete tumour removal with preservation of the facial nerve and even with hearing preservation. The goal of the study was to evaluate the subjective extent of impairment of the patients through the symptoms tinnitus and vertigo after surgery.

Methods: A consecutive series of patients, who underwent surgery for vestibular schwannoma (n=33) and meningioma (n=15) in the cerebellopontine angle was analyzed. In all cases tumour removal was achieved by microsurgery through a lateral suboccipital approach. After a postoperative interval of 3 weeks to 27 months, all patients received a questionnaire. The patients were asked to quantify the subjective extent of impairment by tinnitus and vertigo before and after the operation on a scale from 0 to 10. The return rate of the questionnaires was 64,4%, so that 31 cases could be included in the study (21 vestibular schwannoma, 10 meningioma).

Results: Almost all patients reported a distinct impairment by tinnitus and vertigo, independent on hearing preservation, facial nerve palsy, or other co-morbidities. Improvement of tinnitus existing before surgery occurred in only two patients (6,5%), improvement of vertigo in just one (3,2%). 13 patients without tinnitus or vertigo before surgery reported new symptoms postoperatively with six patients (19,4%) suffering from tinnitus, and seven patients (22,6%) from vertigo after surgery. The mean subjective change with respect to the symptom before and after surgery for tinnitus was 2,6 points (SD=2,96), and 3,8 points (SD=3,16) for vertigo.

Conclusions: Complete tumour removal, preservation of the facial nerve and hearing preservation are not the only criteria for quality of life of patients after tumour removal in the cerebellopontine angle and the IAC. Although more detailed analyses concerning long-term follow-up, psychological criteria and quality of life will have to be further evaluated, there is clear evidence that tinnitus and vertigo are two major factors which influence the postoperative quality of life. The question is how these factors can successfully be included in interdisciplinary treatment strategies in order to minimize their impact.