Exploring the Parametric Space of Tinnitus Suppression in a Patient with a Cochlear Implant

Abstract

ABSTRACT:RESULTS :Educational Objective: The participants should be able to understand the potential role of individualized electrical stimulation of the auditory system in the suppression of tinnitus in patients with cochlear implants.Objectives: Tinnitus is a debilitating condition in which one perceives sound in the absence of external stimuli. Most treatments consist of masking the tinnitus with an external sound that is louder than the tinnitus. We hypothesize that there exists a characteristic tinnitus signature map in each individual that, when found, can be utilized to suppress their tinnitus at a level that is significantly softer than the tinnitus itself.Study Design: Prospective randomized single blinded study in a unique individual with a unilateral cochlear implant in an ear with persistent tinnitus and normal hearing in the non-implanted ear.Methods: Monopolar electrical stimulation at rates from 40 Hz to 10 kHz, stimulation levels from threshold to the tinnitus mixing point, and stimulation placement from apex to base were administered over a time period of 3 to 10 minutes. Successful suppression was defined as the complete elimination of the subject's tinnitus.

Systematic Review on Intra- and Extracochlear Electrical Stimulation for Tinnitus

“…Finally, 33 studies were selected for further analysis and data extraction [ 51 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ]. Of these, 26 were prospective cohort studies.…”

“…Of these, 26 were prospective cohort studies. There were four case series [ 55 , 67 , 69 , 79 ], two case reports [ 70 , 71 ], and one pilot study [ 64 ]. Additionally, one ongoing study at the Mayo clinic, investigating the effect of promontory electrical stimulation, was included in our selection [ 84 ].…”

“…In total, 89 tinnitus patients were treated with intracochlear electrical stimulation, and 1109 with extracochlear stimulation. The sample sizes varied between different study designs, from 1 individual in a case report [ 70 , 71 ] to 168 patients in a parallel group design [ 59 ]. Tinnitus severity was not used as a selection criterion in all studies.…”

“…Nine studies (26%) investigated the effect of intracochlear electrical stimulation on tinnitus [ 51 , 57 , 64 , 65 , 70 , 71 , 72 , 82 , 83 ]. One study (3%) evaluated both types of stimulation: intracochlear stimulation in 3 patients and extracochlear stimulation in 11 patients [ 67 ].…”

“…Among the studies assessing intracochlear electrical stimulation, eight performed acute stimulation [ 57 , 64 , 67 , 70 , 71 , 72 , 82 , 83 ], ranging between 500 milliseconds to 15 min, and two performed chronic stimulation [ 51 , 65 ]. Seven studies assessing extracochlear stimulation performed chronic stimulation [ 63 , 69 , 73 , 76 , 78 , 79 , 84 ].…”