Prospective, Multicenter Study on Tinnitus Changes after Cochlear Implantation

Kim, Dong Kee; Moon, In-Sung; Lim, Hye Jin; Yoo, Shin Young; Heo, Kyung Wook; Bae, Seong Cheon; Moon, Kyung Ray; Lee, Jong Joo; Choung, Yun Hoon; Park, Shi Nae

doi:10.1159/000445164

Cited by 20 publications

(34 citation statements)

References 19 publications

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“…Behaviorally, this is evidenced for instance by enhanced levels of depression and anxiety in tinnitus populations especially, among those with distressing tinnitus (14, 15). Remarkably and similar to other studies (28, 35), average depression and anxiety scores are low in the present CI sample. This may be a favorable condition for allowing a reduction of the tinnitus signal in a bottom-up manner and may part explain the extent of tinnitus reduction by CIs.…”

Section: Discussionsupporting

confidence: 92%

“…A total of 40% of those with preexisting tinnitus indicated conspicuous levels of anxiety and/or depression before implantation, whereas average levels were low which is in accordance with earlier results from CI recipients [e.g., Ref. (28, 29, 35, 36)]. Depression and anxiety scores were reduced by 20% between baseline and the end of follow-up, but these differences did not attain statistical significance.…”

Section: Discussionsupporting

confidence: 85%

“…Two prospective studies on tinnitus following cochlear implantation addressed tinnitus loudness in a similar way, namely, by a visual analog scale (35, 38). The participants of these studies had severe to profound unilateral or bilateral hearing impairment and were provided unilaterally with a CI while hearing was not amplified at the other ear.…”

Section: Discussionmentioning

confidence: 99%

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Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

2017

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Perceptive and receptive aspects of subjective tinnitus like loudness and tinnitus-related distress are partly independent. The high percentage of hearing loss in individuals with tinnitus suggests causality of hearing impairment particularly for the tinnitus percept, leading to the hypothesis that restoration of auditory input has a larger effect on tinnitus loudness than on tinnitus-related distress. Furthermore, it is assumed that high levels of depression or anxiety prevent reductions of tinnitus loudness and distress following restoration of activity in the cochlea. This prospective study investigated the influence of unilateral cochlear implant (CI) on tinnitus in 19 postlingually deafened adults during 6 months following implantation. All had bimodal provision with the other ear being continuously supported by a hearing aid. On the day before CI implantation (T1, T2), and at about 3 and 6 months postsurgery (T3, T4), participants were questioned about their current tinnitus. Loudness was rated on a Numeric Rating Scale, distress was assessed by the TQ12 Tinnitus Questionnaire, and depression and anxiety were recorded with the Hospital Anxiety and Depression Scale. At T2, 79% experienced tinnitus, one participant developed tinnitus after implantation. Following implantation, tinnitus loudness was reduced significantly by 42%, while reductions in tinnitus-related distress (−24%), depression (−20%), and anxiety (−20%) did not attain statistical significance. Significant correlations existed between tinnitus measures, and between postimplantation tinnitus-related distress and anxiety and depression scores. Moreover, improvement of hearing in the CI ear was significantly correlated with reduction in tinnitus loudness. A new aspect of this study is the particular influence of CI provision on perceptive aspects of preexisting tinnitus (hypothesis 1), with the effect size regarding postimplant reduction of perceived tinnitus loudness (1.40) being much larger than effect sizes on the reduction of tinnitus-related distress (0.38), depression (0.53), and anxiety (0.53). Contrary to expectation both tinnitus measures reduce even in the majority of CI recipients with increased levels of anxiety or depression. This suggests that reduction of the tinnitus signal by restoring activity in the cochlea cannot be entirely compensated for by central tinnitus mechanisms and results in a reduction of perceptive and less so of reactive aspects of subjective tinnitus.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

2017

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“…This may happen due to the habituation phenomenon. Despite this fact, there was improvement in tinnitus in both groups, reinforcing the effectiveness of CI surgery in improving tinnitus when is associated with hearing loss, as demonstrated by Kim et al, and Greenberg et al [28] [29]. International Journal of Clinical Medicine Vertigo was present in both groups, but group A showed better outcomes regarding its resolution after cochlear implantation (P = 0.0339), differently of what happened in group B.…”

Section: Discussionsupporting

confidence: 65%

The Influence of Sound Deprivation on Audiologic Outcomes after Cochlear Implantation

Amaral¹,

Reis²,

Pauna³

et al. 2018

IJCM

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The cochlear implant is a prosthesis that is capable to replace listening capability among patients with sensorineural hearing loss. Many studies suggest a negative relationship among duration of sound deprivation and audiometric gain (by means of speech perception test) after cochlear implantation. We evaluated surgical and audiologic results among post-lingual deafened adults, in different times of sound deprivation, and correlated with social isolation, presence of vertigo or tinnitus, and the speech therapy yield, between pre-and post-operative stages. A retrospective study was conducted on patients with post-lingual hearing loss, aged over 18 years old who underwent cochlear implant surgery in a public hospital from 2004 to 2014. Audiological, sociodemographic questionnaire, and manifestations of vertigo and tinnitus, during pre-and post-operative stages, were compared and correlating to the different periods of sound deprivation. Two groups were studied. The group A was composed of 38 participants (14 male and 24 female) with sound deprivation of less than 10 years; and group B was composed of 17 participants (8 male and 9 female) with sound deprivation longer than 10 years. We found no differences regarding age, sex, duration of sound deprivation, mean pure-tone audiometric results (pre-and post-surgery), and speech perception tests (pre-operatively). After one year of the surgery, we observed a significant difference between both groups, with a better performance to group A. The results of speech perception test, after cochlear implantation in group B, were worse than the results obtained in group A, although these correlations are not determinant whether to perform cochlear implant surgery or not.

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“…Nach der CI-Operation war das Ohrgeräusch bei 10 Patienten (25 %) eliminiert, bei 16 (40 %) deutlich verbessert. Insgesamt waren die Ergebnisse der entsprechenden Fragebögen (THI und BDI) 6 Monate nach CI signifikant besser[113].Moderne digitale Hörgeräte haben mittlerweile in der Tinnitustherapie einen hohen Stellenwert. Besonders seitdem durch eine offene, sehr gut tolerable Versorgung mit externem Hörer und guter Rückkopplungs-und Störgeräuschunterdrückung auch Pa tienten mit Hochtonschwerhörigkeit und hochfrequentem Tinnitus versorgt werden können, ist ein entscheidender Fortschritt gelungen.…”

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Hörgeräte: Indikationen, Technologie, Anpassung und Qualitätskontrolle

Hoppe

Hesse

2017

Laryngo-Rhino-Otol

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Hearing loss can be caused by a number of different pathological conditions. Some of them can be successfully treated, mainly by surgery, depending on the individual's disease process. However, the treatment of chronic sensorineural hearing loss with damaged cochlear structures usually needs hearing rehabilitation by means of technical amplification. During the last 2 decades tremendous improvements in hearing aid technology led to a higher quality in the hearing rehabilitation process. For example, due to sophisticated signal processing the acoustic feedback path could be reduced and hence open fitting options are available for even more subjects. In particular for high-frequency hearing loss the use of open fitting is an option. Both the users' acceptance and the perceived sound quality were significantly increased by open fittings.However, we are still faced with a low level of readiness in many hearing impaired subjects to accept acoustic amplification. Since ENT specialists play a key-role in hearing aid provision, they should promote early hearing aid rehabilitation and include this in the counselling even in subjects with mild and moderate hearing loss. Recent investigations demonstrated the benefit of early hearing aid use in this group of patients since this may help to reduce subsequent damages as auditory deprivation, social isolation, development of dementia, and cognitive decline. For subjects with tinnitus, hearing aids may also support masking by environmental sounds and enhance cortical inhibition.The present paper describes the latest development of hearing aid technology and the current state of the art for amplification modalities. Implications for both hearing aid indication and provision are discussed.

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Prospective, Multicenter Study on Tinnitus Changes after Cochlear Implantation

Cited by 20 publications

References 19 publications

Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

The Influence of Sound Deprivation on Audiologic Outcomes after Cochlear Implantation

Hörgeräte: Indikationen, Technologie, Anpassung und Qualitätskontrolle

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