The effects of unilateral cochlear implantation on the tinnitus handicap inventory and the influence on quality of life

Amoodi, Hosam; Mick, Paul; Shipp, David; Friesen, Lendra; Nedzelski, Julian M.; Chen, Joseph M.; Lin, Vincent

doi:10.1002/lary.21851

Cited by 55 publications

(83 citation statements)

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“…Cochlear implantation has been advocated by several authors as a treatment for tinnitus in patients with hearing loss. 19,20 The theory behind this intervention is that CI addresses the changes in neural activity caused by reduced auditory input, thought to be responsible for tinnitus. In a prospective study of 142 patients, Amoodi et al 20 reported that CI exerted a significant suppressive effect on tinnitus in 66% of their population (including 7 patients with deafness attributed to MD).…”

Section: Discussionmentioning

confidence: 99%

“…19,20 The theory behind this intervention is that CI addresses the changes in neural activity caused by reduced auditory input, thought to be responsible for tinnitus. In a prospective study of 142 patients, Amoodi et al 20 reported that CI exerted a significant suppressive effect on tinnitus in 66% of their population (including 7 patients with deafness attributed to MD). Regarding vestibular symptoms, it is encouraging that the introduction of a current emitting electrode within the cochlear microenvironment does not induce vertiginous symptoms in patients with a tendency toward endolymphatic hydrops, as vestibular dysfunction has been reported in up to one third of cochlear implant recipients.…”

Section: Discussionmentioning

confidence: 99%

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Cochlear Implantation in Ménière’s Disease

Fife

Lewis

May

et al. 2014

JAMA Otolaryngol Head Neck Surg

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Ménière's disease (MD) is characterized by cochleovestibular dysfunction that manifests as fluctuating sensorineural hearing loss (SNHL), episodic vertigo, aural fullness, and tinnitus. A review of the available literature revealed that only a handful of English-language articles investigating CI in the setting of MD have been published. [4][5][6][7][8] Most of these are single case reports and opinion articles and focus primarily on the effects of CI on hearing performance in patients with MD. Only 1 study has addressed the effects of CI on the nonhearing aspects of MD. 4Patients with severe to profound bilateral SNHL and poor word recognition capability due to MD stand to experience considerable benefit from CI. The objectives of this study are to (1) determine whether CI in patients with MD improves hearing performance as measured by standard CI audiometric testing and (2) describe the impact of CI on subjective auditory and vestibular quality-of-life measures.IMPORTANCE Though the effects of cochlear implantation (CI) on patients with hearing loss has been well described, its effect on the auditory and vestibular symptoms in patients with Ménière's disease (MD) has not been firmly established.OBJECTIVES To determine whether CI in patients with MD improves hearing performance as measured by standard post-CI audiometric testing and to describe the impact of CI on subjective auditory and vestibular quality-of-life measures. DESIGN, SETTING, AND PARTICIPANTSRetrospective review of all patients with MD 18 years or older who met diagnostic criteria for definite MD and underwent CI at Wake Forest University Baptist Medical Center, a tertiary care academic medical center, from 2000 through 2012.INTERVENTIONS Patients were invited to answer questions regarding their current hearing ability, subjective perception of symptoms, and functional status related to their MD before and after CI. Patient records were reviewed for pertinent information. Results were then analyzed for statistical significance. MAIN OUTCOMES AND MEASURESPre-CI and post-CI sentence testing scores, frequency and severity of MD vestibular and auditory symptoms via the MD Functional Level Scale (FLS), and hearing quality of life via the Hearing Handicap Index were reviewed.RESULTS Eleven CIs were performed in 10 patients. Mean long-term follow-up was 41 months. The mean age at first implantation was 64 years. The mean sentence testing scores in quiet improved from 22.8% before CI to 77.0% after CI (P < .001) at the most recent follow-up. Mean (SD) pre-CI and post-CI MD-FLS vestibular scores were similar: 3.9 (1.9) and 3.4 (1.9) (P = .52).CONCLUSIONS AND RELEVANCE Patients with MD who undergo CI are capable of achieving substantial receptive communication improvement comparable to the gains experienced by patients without MD. Implantation seems to neither adversely alter the natural history of vestibular function nor notable exacerbate auditory symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cochlear Implantation in Ménière’s Disease

Fife

Lewis

May

et al. 2014

JAMA Otolaryngol Head Neck Surg

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“…Subjects with tinnitus report poor speech perception, difficulty falling asleep, inability to concentrate, insecurity, and depression [Tyler and Baker, 1983]. In conventional CI recipients, who have bilateral moderate-to-profound SNHL, the cochlear implantation procedure and/or CI device use may influence the presence and/or severity of tinnitus [Pan et al, 2009;Arnoodi et al, 2011]. Van de Heyning et al [2008] explored whether a similar effect would occur in patients who presented with substantial UHL and severe intractable tinnitus.…”

Section: Introductionmentioning

confidence: 99%

Effect of Cochlear Implantation on Quality of Life in Adults with Unilateral Hearing Loss

et al. 2017

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Objective: Patients with moderate-to-profound sensorineural hearing loss in 1 ear and normal hearing in the contralateral ear, known as unilateral hearing loss (UHL) or single-sided deafness (SSD), may experience improved quality of life with the use of a cochlear implant (CI) in the affected ear. Quality of life assessment before and after implantation may reveal changes to aspects of hearing beyond those explicitly evaluated with behavioral measures. Methods: The present report completed 2 experiments investigating quality of life outcomes in CI recipients with UHL. The first experiment assessed quality of life during the 1st year of device use with 3 questionnaires: the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Tinnitus Handicap Inventory. Twenty subjects were evaluated preoperatively and 1, 3, 6, 9, and 12 months post-activation. Quality of life results were compared over the study period using traditional scoring methods and the SSQ pragmatic subscales. Subscales specific to localization and speech perception in noise were compared to behavioral measures at the preoperative and 12-month intervals. The 2nd experiment evaluated quality of life preoperatively and at the 12-month interval for CI recipients with UHL and CI recipients with bilateral hearing loss, including conventional CI users and those listening with electric-acoustic stimulation (EAS). The 3 cohorts differed in CI candidacy criteria, including the amount of residual hearing in the contralateral ear. Results: For subjects with moderate-to-profound UHL, receipt of a CI significantly improved quality of life, with benefits noted as early as 1 month after initial activation. The UHL cohort reported less perceived difficulty at the pre- and postoperative intervals than the conventional CI and EAS cohorts, which may be due to the presence of the normal-hearing ear. Each group experienced a significant benefit in quality of life on the APHAB with CI use. Conclusions: Cochlear implantation in cases of substantial UHL may offer significant improvements in quality of life. Quality of life measures revealed a reduction in perceived tinnitus severity and subjective improvements in speech perception in noise, spatial hearing, and listening effort. While self-report of difficulties were lower for the UHL cohort than the conventional CI and EAS cohorts, subjects in all 3 groups reported an improvement in quality of life with CI use.

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“…Tinnitus is generally not eliminated, but can be increased by this procedure (Cope et al, 2011) although the effect was found to vary from increased to decreased tinnitus or no effect (Mollar et al, 1993). Tinnitus can be associated with severe deafness and can generally be ameliorated to degree with the electrical stimulation of a cochlear implant (Amoodi et al, 2011;Arndt et al, 2011;Pan et al, 2009). What then is the mechanism that produces tinnitus with just being in silence or immediately having an eight nerve sectioning, this cannot be the result of complex neural plastic changes in the brain, it is most likely a release from neural inhibition in the peripheral neural structures, probably acting the spiral ganglia by the central auditory system.…”

Section: A Tinnitus Definitionmentioning

confidence: 99%

Home Medical Device for Tinnitus Treatment

Lenhardt¹

2011

Up to Date on Tinnitus

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The effects of unilateral cochlear implantation on the tinnitus handicap inventory and the influence on quality of life

Cited by 55 publications

References 20 publications

Cochlear Implantation in Ménière’s Disease

Cochlear Implantation in Ménière’s Disease

Effect of Cochlear Implantation on Quality of Life in Adults with Unilateral Hearing Loss

Home Medical Device for Tinnitus Treatment

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