How effect is educational counseling prior to middle ear surgery for patients with both middle ear diseases and consistent tinnitus?

Background: The management of patients with tinnitus who receive middle ear surgery has not been established. Aims: The aim of this study is (1) how many patients who receive middle ear surgery have tinnitus and (2) how educational counselling and middle ear surgery is effective with consistent tinnitus. Subjects and methods: Twenty four cases out of 90 cases accounted for 26.7% of the middle ear diseases scheduled for surgery in the past two years. Of the 42 patients with hearing loss in the second year, 14 had consistent and intermittent tinnitus. Among them we have 6 patients complaining consistent tinnitus and we examined the change in the Tinnitus Handicap Inventory (THI) for patients with tinnitus before and after surgery. Results: Ten out of 13 cases (about 76.9%) reported that postoperative tinnitus improved. THI score in two cases showed worse. Conclusions and significance: Two cases showed worse THI in both mixed hearing loss cases with a small hearing improvement. The mechanism of improvement is similar to tinnitus retraining therapy including hearing aid because the increase in external sound input through hearing restoration after surgery to avoid silence.