Tinnitus in patients with chronic otitis media before and after middle ear surgery

The objective of this study was to investigate the clinical features of tinnitus in patients with chronic otitis media (COM) and to evaluate changes in tinnitus following middle ear surgery in relation to audiologic outcome. Medical records were reviewed for 117 patients with COM who underwent middle ear surgery between March 2009 and March 2010. Of them, 44 patients who pre-operatively reported tinnitus on a tinnitus questionnaire and 28 patients who completed a tinnitus questionnaire 8 weeks after surgery were evaluated to determine the clinical characteristics of tinnitus in patients with COM and any change in tinnitus following middle ear surgery, respectively. New tinnitus symptoms that developed after surgery were also evaluated in previously asymptomatic patients. The pre-operative incidence of tinnitus in patients with COM was 43% (50/117), with 87% of these patients displaying sensorineural tinnitus. After middle ear surgery, tinnitus handicap inventory scores were reduced in 82% of patients (23/28). Mean values of loudness, annoyance, effect on life, and awareness of tinnitus were also significantly reduced. One patient displayed newly developed tinnitus after surgery. Analysis of the relationship between improvement in tinnitus and audiologic outcome demonstrated that the group of patients whose tinnitus handicap inventory was reduced by more than 10 showed significantly greater improvements in mean air-conduction thresholds than did patients in the other group. In conclusion, following middle ear surgery, most patients experienced a reduction in tinnitus and restored hearing, with surgery perceived as an important contributory factor.