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Tang D, Tran Y, Lo C, Lee JN, Turner J, McAlpine D, McMahon C, Gopinath B. The Benefits of Cochlear Implantation for Adults: A Systematic Umbrella Review. Ear Hear 2024; 45:801-807. [PMID: 38233980 DOI: 10.1097/aud.0000000000001473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVES The uptake of cochlear implants among adults who could benefit (based on pure-tone audiometry) in developed countries is estimated to be less than 10%. Concerns about potential surgical complications, fear of losing residual hearing, and limited awareness about the benefits of this intervention contribute to the low adoption rate. To enhance quality of life and improve the uptake of cochlear implants, it is essential to have a clear understanding of their benefits. DESIGN This umbrella review aims to summarize the major benefits of cochlear implant usage in adults, by synthesizing findings from published review articles. A comprehensive search of databases including MEDLINE, EMBASE, PsycINFO, and Google Scholar, was conducted. The search was limited to English-language review articles published between 1990 and 2022, focusing on cochlear implant outcomes in at least 5 adults (aged ≥18 years). Two independent reviewers screened titles, abstracts, and full-text articles, and conducted a quality assessment using the Joanna Briggs Checklist for Systematic Reviews and Research Syntheses. RESULTS Forty-two articles were included in this review. There were 15 systematic reviews with meta-analysis, 25 systematic reviews without meta-analysis, and 2 systematic scoping reviews. All 42 articles underwent quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses, of which 40% (n = 17) satisfied 9 out of 11 quality criteria. This umbrella review shows that cochlear implants are associated with improvements in speech perception and recognition as well as improved quality of life and cognition. These benefits are observed in a significant proportion of adults undergoing the procedure, highlighting its effectiveness as a viable intervention for individuals with severe to profound hearing loss. CONCLUSIONS The potential benefits of cochlear implantation appear to outweigh the risks and complications associated with the procedure. It is recommended that adults with severe to profound hearing loss in particular, engage in informed discussions with healthcare professionals to consider cochlear implantation as a viable treatment option.
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Affiliation(s)
- Diana Tang
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Yvonne Tran
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Charles Lo
- Department of Management, Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Jien Nien Lee
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Jessica Turner
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - David McAlpine
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Catherine McMahon
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Bamini Gopinath
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
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Langguth B, de Ridder D, Schlee W, Kleinjung T. Tinnitus: Clinical Insights in Its Pathophysiology-A Perspective. J Assoc Res Otolaryngol 2024; 25:249-258. [PMID: 38532055 DOI: 10.1007/s10162-024-00939-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Tinnitus, the perception of sound without a corresponding external sound source, and tinnitus disorder, which is tinnitus with associated suffering, present a multifaceted clinical challenge due to its heterogeneity and its incompletely understood pathophysiology and especially due to the limited therapeutic options. In this narrative review, we give an overview on various clinical aspects of tinnitus including its heterogeneity, contributing factors, comorbidities and therapeutic pathways with a specific emphasis on the implications for its pathophysiology and future research directions. Tinnitus exhibits high perceptual variability between affected individuals (heterogeneity) and within affected individuals (temporal variability). Hearing loss emerges as predominant risk factor and the perceived pitch corresponds to areas of hearing loss, supporting the compensatory response theory. Whereas most people who have tinnitus can live a normal life, in 10-20% tinnitus interferes severely with quality of life. These patients suffer frequently from comorbidities such as anxiety, depression or insomnia, acting as both risk factors and consequences. Accordingly, neuroimaging studies demonstrate shared brain networks between tinnitus and stress-related disorders shedding light on the intricate interplay of mental health and tinnitus. The challenge lies in deciphering causative relationships and shared pathophysiological mechanisms. Stress, external sounds, time of day, head movements, distraction, and sleep quality can impact tinnitus perception. Understanding these factors provides insights into the interplay with autonomic, sensory, motor, and cognitive processes. Counselling and cognitive-behavioural therapy demonstrate efficacy in reducing suffering, supporting the involvement of stress and anxiety-related networks. Hearing improvement, especially through cochlear implants, reduces tinnitus and thus indirectly validates the compensatory nature of tinnitus. Brain stimulation techniques can modulate the suffering of tinnitus, presumably by alteration of stress-related brain networks. Continued research is crucial for unravelling the complexities of tinnitus. Progress in management hinges on decoding diverse manifestations, identifying treatment-responsive subtypes, and advancing targeted therapeutic approaches.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
- Interdisciplinary Tinnitus Clinic, University of Regensburg, Regensburg, Germany.
| | - Dirk de Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Clinic, University of Regensburg, Regensburg, Germany
- Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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van Genuchten S, Gilles A, Mertens G, Andries E, Cardon E, Van Rompaey V, Lammers M, Vanderveken OM, Jacquemin L. Tinnitus suppression by means of cochlear implantation: does it affect cognition? Eur Arch Otorhinolaryngol 2024; 281:2281-2291. [PMID: 38052757 DOI: 10.1007/s00405-023-08339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Recent literature suggests that tinnitus can impact cognition, but results were varied due to a diversity in investigated aspects of cognition and utilized tests, as well as the possible influence of confounding factors. The purpose of this study was to assess the impact of tinnitus loudness on cognition by use of a within-subjects design in patients with a cochlear implant (CI). In this population, tinnitus loudness can be modulated by switching the CI on or off as CI is known to highly suppress tinnitus. METHODS A total of 18 CI users completed two versions of the Repeatable Battery for Assessment of Neuropsychological Status for Hearing Impaired individuals (RBANS-H), once in unaided condition and once in best aided condition. Tinnitus suppression was defined as a difference in score on a visual-analogue scale (VAS) of at least one point out of ten between these two conditions. RESULTS No significant differences in RBANS-H scores were found between the suppression and no suppression group, nor for the suppression group alone. No significant correlations between tinnitus loudness and RBANS-H were found, neither for the suppression group alone, nor for the group as a whole. CONCLUSION The current study shows no significant effect of tinnitus loudness on cognition, which contradicts previous literature. This discrepancy could be explained by the use of a within-subjects design, which controls for confounding factors. Future research should include a larger and more diverse study sample to draw definitive conclusions on this topic.
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Affiliation(s)
- Sarah van Genuchten
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Annick Gilles
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
| | - Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Ellen Andries
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Emilie Cardon
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Marc Lammers
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Kang YJ, Zheng Y. Current understanding of subjective tinnitus in adults. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08633-w. [PMID: 38632112 DOI: 10.1007/s00405-024-08633-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE An up-to-date overview of epidemiology, etiology and pathophysiological mechanisms, diagnostic and evaluation methods, current treatment status and future directions of subjective tinnitus in adults. METHODS Review of current evidence-based literature on subjective tinnitus in adults. RESULTS The prevalence of subjective tinnitus in the adult population is estimated to be around 14%, and it tends to increase with age. Subjective tinnitus is a complex condition with multiple factors contributing to its origin. However, the exact causes and underlying mechanisms remain unknown. Potential causes may include hearing loss, dysfunction in the somatosensory system, and auditory cortical dysfunction, although severe underlying pathology is rare. Currently, diagnosis primarily relies on patient self-reported medical history and physician-based clinical assessment due to the lack of objective testing. Various treatment and management options have been proposed, but their effectiveness varies, and there is no universally agreed-upon treatment option. CONCLUSIONS Tinnitus is a complex and heterogeneous disease with a high incidence rate and a tendency to increase with age. A holistic perspective is needed to understand the generation, perception, and emotional responses to tinnitus. Diagnosis requires a comprehensive assessment based on medical history and relevant examinations, identification of concurrent psychosomatic comorbidities, and active pursuit of objective diagnostic methods. At the same time, on the basis of existing treatment plans and combining emerging technologies, we will develop new personalized, precise, and combined treatment plans.
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Affiliation(s)
- Yao-Jie Kang
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Otolaryngology-Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Tujia and Miao Autonomous Prefecture, China
| | - Yun Zheng
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China.
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Lailach S, Stephan P, Martin J, Zahnert T, Neudert M. Influence of depressive disorders, stress, and personality traits on quality of life after cochlear implantation. Eur Arch Otorhinolaryngol 2024; 281:1717-1734. [PMID: 37917166 PMCID: PMC10942889 DOI: 10.1007/s00405-023-08284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE This study aimed to determine whether preoperative depressiveness, stress, and personality influence quality of life (QOL) after cochlear implant (CI) surgery. METHODS In this prospective study, 79 patients undergoing CI surgery were evaluated preoperatively and 12 months postoperatively. Disease-specific QOL was assessed with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and general QOL with the WHOQOL-BREF. Depressiveness and stress were assessed with the Patient Health Questionnaire (PHQ-D). The Charlson Comorbidity Index (CCI) was used to classify comorbidities. The Big Five Personality Test (B5T) was used to assess the basic personality dimensions. Speech comprehension was evaluated in quiet with the Freiburg monosyllable test and in noise with the Oldenburg sentence test. RESULTS After CI surgery, the total NCIQ score improved significantly (Δ 17.1 ± 14.7, p < 0.001). General QOL (WHOQOL-BREF, Δ 0.4 ± 9.9, p = 0.357), stress (Δ 0.25 ± 3.21, p = 0.486), and depressiveness (Δ 0.52 ± 3.21, p = 0.121) were unaffected by CI surgery. Patients without elevated depressiveness (p < 0.01) or stress (p < 0.001) had significantly better total NCIQ scores. The results of the multiple regression analyses show that, after adjusting for the CCI, personality, age, and mental health stress (ß = - 0.495, p < 0.001) was significantly associated with postoperative NCIQ outcome scores. Depressiveness and neuroticism had the strongest influence on the generic QOL (ß = - 0.286 and ß = - 0.277, p < 0.05). CONCLUSION Stress symptoms and personality traits are significant predictive factors for disease-specific QOL, as well as hearing status. This should be considered in the preoperative consultation and in optimizing the rehabilitation process.
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Affiliation(s)
- Susen Lailach
- Faculty of Medicine Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Saxony, Germany.
| | - Paula Stephan
- Faculty of Medicine Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Saxony, Germany
| | - Johanna Martin
- Faculty of Medicine Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Saxony, Germany
| | - Thomas Zahnert
- Faculty of Medicine Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Saxony, Germany
| | - Marcus Neudert
- Faculty of Medicine Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Saxony, Germany
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Gninenko N, Trznadel S, Daskalou D, Gramatica L, Vanoy J, Voruz F, Robyn CL, Spadazzi A, Yulzari A, Sitaram R, Van De Ville D, Senn P, Haller S. Functional MRI Neurofeedback Outperforms Cognitive Behavioral Therapy for Reducing Tinnitus Distress: A Prospective Randomized Clinical Trial. Radiology 2024; 310:e231143. [PMID: 38349241 DOI: 10.1148/radiol.231143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Background Cognitive behavioral therapy (CBT) is the current standard treatment for chronic severe tinnitus; however, preliminary evidence suggests that real-time functional MRI (fMRI) neurofeedback therapy may be more effective. Purpose To compare the efficacy of real-time fMRI neurofeedback against CBT for reducing chronic tinnitus distress. Materials and Methods In this prospective controlled trial, participants with chronic severe tinnitus were randomized from December 2017 to December 2021 to receive either CBT (CBT group) for 10 weekly group sessions or real-time fMRI neurofeedback (fMRI group) individually during 15 weekly sessions. Change in the Tinnitus Handicap Inventory (THI) score (range, 0-100) from baseline to 6 or 12 months was assessed. Secondary outcomes included four quality-of-life questionnaires (Beck Depression Inventory, Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory, and World Health Organization Disability Assessment Schedule). Questionnaire scores between treatment groups and between time points were assessed using repeated measures analysis of variance and the nonparametric Wilcoxon signed rank test. Results The fMRI group included 21 participants (mean age, 49 years ± 11.4 [SD]; 16 male participants) and the CBT group included 22 participants (mean age, 53.6 years ± 8.8; 16 male participants). The fMRI group showed a greater reduction in THI scores compared with the CBT group at both 6 months (mean score change, -28.21 points ± 18.66 vs -12.09 points ± 18.86; P = .005) and 12 months (mean score change, -30 points ± 25.44 vs -4 points ± 17.2; P = .01). Compared with baseline, the fMRI group showed improved sleep (mean score, 8.62 points ± 4.59 vs 7.25 points ± 3.61; P = .006) and trait anxiety (mean score, 44 points ± 11.5 vs 39.84 points ± 10.5; P = .02) at 1 month and improved depression (mean score, 13.71 points ± 9.27 vs 6.53 points ± 5.17; P = .01) and general functioning (mean score, 24.91 points ± 17.05 vs 13.06 points ± 10.1; P = .01) at 6 months. No difference in these metrics over time was observed for the CBT group (P value range, .14 to >.99). Conclusion Real-time fMRI neurofeedback therapy led to a greater reduction in tinnitus distress than the current standard treatment of CBT. ClinicalTrials.gov registration no.: NCT05737888; Swiss Ethics registration no.: BASEC2017-00813 © RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Nicolas Gninenko
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Stéphanie Trznadel
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Dimitrios Daskalou
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Luca Gramatica
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Julie Vanoy
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - François Voruz
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Claudia Lardi Robyn
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Anne Spadazzi
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Aude Yulzari
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Ranganatha Sitaram
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Dimitri Van De Ville
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Pascal Senn
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
| | - Sven Haller
- From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.)
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7
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Lee HY, Jung DJ. Recent Updates on Tinnitus Management. J Audiol Otol 2023; 27:181-192. [PMID: 37872753 PMCID: PMC10603282 DOI: 10.7874/jao.2023.00416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/25/2023] Open
Abstract
In this comprehensive review, we discuss recent updates on tinnitus evaluation and treatment. Tinnitus evaluation commences with comprehensive medical history taking and audiological evaluation, which can provide valuable insight into the nature and extent of auditory disturbances. Additionally, tinnitus evaluation includes investigation of psychosomatic comorbidities to determine the intricate interplay between psychological factors and tinnitus perception. Various therapeutic approaches are available to minimize the burden of tinnitus. Cognitive behavioral therapy reshapes negative thought patterns and behaviors that are closely associated with tinnitus-induced distress. Acceptance and commitment therapy fosters mindfulness and value-aligned actions to address emotional effects. Tinnitus retraining therapy combines counseling and sound therapy for habituation. Tailor-made notched music therapy offers customized auditory experiences for symptom relief. Hearing aids and cochlear implants compensate for hearing loss and associated stress. Both neuromodulation and neurofeedback may be potentially useful. The role of pharmacotherapy and dietary supplements remains uncertain. Physiotherapy and head-neck manipulation relieve tinnitus associated with orofacial factors. Virtual reality, smartphone applications, and photobiomodulation may serve as novel therapeutic avenues. Although promising interventions are available, further research is warranted to confirm their effectiveness and long-term effects.
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Affiliation(s)
- Ho Yun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Da Jung Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
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8
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Rasmussen KD, West NC, Bille M, Cayé-Thomasen P. Tinnitus suppression in a prospective cohort of 45 cochlear implant recipients: occurrence, degree and correlates. Eur Arch Otorhinolaryngol 2023; 280:4073-4082. [PMID: 37099145 DOI: 10.1007/s00405-023-07921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/08/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE To determine tinnitus prevalence and severity in a cohort of unselected first-time cochlear implant (CI) recipients whose primary motive for CI was sensorineural hearing loss (SNHL), and to evaluate the effect of CI on tinnitus after cochlear implantation. METHODS Prospective longitudinal study of 45 adult CI recipients with moderate to profound SNHL. Patients completed the Danish version of the Tinnitus Handicap Inventory (THI) and a visual analogue scale (VAS) for tinnitus burden before implantation, 4 months after implantation and 14 months after implantation. RESULTS The study included 45 patients, of which 29 (64%) had pre-implant tinnitus. Median THI score (IQR) significantly decreased from 20 (34) to 12 (24) at first follow-up (p < 0.05) and to 6 points (17) at second follow-up (p < 0.001). Median VAS (IQR) for tinnitus burden decreased from 33 (62) to 17 (40; p = 0.228) and 12 (27, p < 0.05) at the first and second follow-ups, respectively. Tinnitus was totally suppressed in 19% of patients, improved in 48%, remained unchanged in 19% and worsened in 6%. 2 patients reported new tinnitus. At the second follow-up, 74% of patients had slight or no tinnitus handicap, 16% had mild handicaps, 6% had moderate handicaps, and 3% had severe handicaps. High pre-implant THI and VAS scores correlated with greater decrease in THI scores over time. CONCLUSION 64% of the patients with SNHL had pre-implant tinnitus, which was decreased 4 and 14 months after implantation. Overall, 68% of patients with tinnitus improved their tinnitus handicap after CI. Patients with higher THI and VAS scores had a larger decline and the highest benefits in terms of tinnitus handicap improvement. The study findings demonstrate that the majority of patients with moderate to profound SNHL eligible for cochlear implantation benefit from complete or partial tinnitus suppression and improved quality of life after implantation.
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Affiliation(s)
- Kasper Dyre Rasmussen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Niels Cramer West
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Bille
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Per Cayé-Thomasen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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9
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Chau IY, Li SYH, Shiao AS, Islam AS, Coelho DH. Early effects of very early cochlear implant activation on tinnitus. J Chin Med Assoc 2023; 86:850-853. [PMID: 37481759 DOI: 10.1097/jcma.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Cochlear implantation (CI) has long been the standard of care for patients with severe-to-profound hearing impairment. Yet the benefits of CI extend far beyond speech understanding, with mounting recent literature supporting its role in tinnitus abatement. However, those studies have uniformly analyzed the effects of tinnitus after the traditional 3-4 weeks waiting period between CI surgery and device activation. As many clinics are shifting these waiting intervals to become shorter (in some cases within 24 hours, little is known about tinnitus abatement very early in the postoperative period. The aim of this study was to compare preoperative and postoperative tinnitus handicaps in this unique but growing population of very early-activated patients. METHODS Twenty-seven adults with severe-to-profound hearing impairment with chronic tinnitus (>6 months) were included. Patients with concomitant psychiatric disorders were excluded. All patients were implanted with the same array and were switched on within 24 hours after the surgery. Tinnitus Handicap Inventory (THI) was recorded preoperatively, immediately after activation at 24 hours postoperatively, at 1 week, 2 weeks, and I month after activation. Wilcoxon signed-rank test was used to compare values between preoperative assessment and respective fitting sessions. RESULTS Mean THI 24 hours after implantation increased in comparison to that assessed preoperatively (77.6 vs 72.5, p = 0.001). By 1 week after surgery, the THI had decreased to 54.9 ( p < 0.001). This trend continued and was statistically significant at 2 weeks (36.0, p < 0.001) and 1 month (28.5, p < 0.001). CONCLUSION On average, most patients with tinnitus will note a significant improvement in their tinnitus handicap when activated within 24 hours of CI. However, tinnitus does increase between surgery and 24 hours, most likely reflecting not only intracochlear changes, but modulation of the entire auditory pathway. Following this early rise, the tinnitus continues to abate over the following month. Patients with tinnitus may benefit from early activation, although should be counseled that they may experience an exacerbation during the very early postoperative period.
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Affiliation(s)
- Ivy Yenwen Chau
- Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | | | - An-Suey Shiao
- Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Albina S Islam
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Daniel H Coelho
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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10
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Langguth B, Kleinjung T, Schlee W, Vanneste S, De Ridder D. Tinnitus Guidelines and Their Evidence Base. J Clin Med 2023; 12:jcm12093087. [PMID: 37176527 PMCID: PMC10178961 DOI: 10.3390/jcm12093087] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/17/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
Evidence-based medicine (EBM) is generally accepted as the gold standard for high-quality medicine and, thus, for managing patients with tinnitus. EBM integrates the best available scientific information with clinical experience and patient values to guide decision-making about clinical management. To help health care providers and clinicians, the available evidence is commonly translated into medical or clinical guidelines based on a consensus. These involve a systematic review of the literature and meta-analytic aggregation of research findings followed by the formulation of clinical recommendations. However, this approach also has limitations, which include a lack of consideration of individual patient characteristics, the susceptibility of guideline recommendations to material and immaterial conflicts of interest of guideline authors and long latencies till new knowledge is implemented in guidelines. A further important aspect in interpreting the existing literature is that the absence of evidence is not evidence of absence. These circumstances could result in the decoupling of recommendations and their supporting evidence, which becomes evident when guidelines from different countries differ in their recommendations. This opinion paper will discuss how these weaknesses can be addressed in tinnitus.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Clinic, University of Regensburg, 93053 Regensburg, Germany
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Clinic, University of Regensburg, 93053 Regensburg, Germany
- Institute for Information and Process Management, Eastern Switzerland University of Applied Sciences, 9001 St. Gallen, Switzerland
| | - Sven Vanneste
- Trinity Institute for Neuroscience, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
- School of Psychology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin 9016, New Zealand
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11
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Olze H, Ketterer MC, Péus D, Häußler SM, Hildebrandt L, Gräbel S, Szczepek AJ. Effects of auditory rehabilitation with cochlear implant on tinnitus prevalence and distress, health-related quality of life, subjective hearing and psychological comorbidities: Comparative analysis of patients with asymmetric hearing loss (AHL), double-sided (bilateral) deafness (DSD), and single-sided (unilateral) deafness (SSD). Front Neurol 2023; 13:1089610. [PMID: 36712436 PMCID: PMC9877424 DOI: 10.3389/fneur.2022.1089610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Auditory rehabilitation with a cochlear implant (CI), in many cases, positively impacts tinnitus. However, it is unclear if the tinnitus-related benefit of CI is equal for patients with various indications for CI. Therefore, this study aimed to determine differences in tinnitus prevalence and distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities between patients diagnosed with asymmetric hearing loss (AHL), single-sided (unilateral) deafness (SSD), and double-sided (bilateral) deafness (DSD) before and six months after cochlear implantation. Methods One hundred-one CI candidates were included in this prospective study (39 AHL patients, 23 DSD patients, and 39 SSD patients). The patients completed questionnaires measuring tinnitus distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities before and 6 months after CI. Results The prevalence of tinnitus in the entire cohort (80.2% before CI) decreased 6 months after CI to 71.3%. The DSD group had the lowest tinnitus prevalence at both time points. The degree of tinnitus-induced distress decreased significantly in all three groups after CI. Differences in quality of life, subjective hearing, and psychological comorbidities between the groups at the study onset disappeared after CI. Significant correlations existed between anxiety, depression, and tinnitus distress in AHL and SSD but not in DSD patients before and after CI. Discussion Our results demonstrate significant differences between the three groups of CI candidates, which might affect the implantation outcome. These differences suggest a need for personalized psychological counseling during the auditory rehabilitation process, focusing on anxiety and depressive symptoms for SSD and AHL patients.
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Affiliation(s)
- Heidi Olze
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany,*Correspondence: Heidi Olze ✉
| | - Manuel Christoph Ketterer
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Dominik Péus
- Department of Otorhinolaryngology, University of Oldenburg, Oldenburg, Germany
| | - Sophia Marie Häußler
- Department of Otorhinolaryngology, Skull Base Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lynn Hildebrandt
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Agnieszka J. Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
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12
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Grundfast KM, Jamil TL. Evaluation and Management of Tinnitus: Are There Opportunities for Improvement? Otolaryngol Head Neck Surg 2023; 168:45-58. [PMID: 35349391 DOI: 10.1177/01945998221088286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/02/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To review current information about diagnosis and management of tinnitus aiming to identify opportunities for achieving a cost-effective, efficient, evidence-based approach that meets the needs of tinnitus sufferers. DATA SOURCES PubMed/MEDLINE. REVIEW METHODS In total, 249 relevant published reports were reviewed. Pertinent keywords and MeSH terms identified reports via PubMed and EMBASE. Acknowledged experts were consulted on ways to improve tinnitus management. CONCLUSIONS There may be opportunities to improve evaluation and management of patients with tinnitus using modern modes of communication and a multidisciplinary therapeutic approach. IMPLICATIONS FOR PRACTICE Tinnitus can adversely affect quality of life while being time-consuming and costly to evaluate and manage. Based on both personal experience and the reports of others, patients with tinnitus who choose to see a physician primarily want to know two things: (1) that the tinnitus that is so distressing will not remain at the same level of severity forever and (2) that something can be done to help cope with the tinnitus that is so annoying. Recent advancements in internet communications, social media, information technology, artificial intelligence, machine learning, holistic medical care, mind-body integrative health care, and multidisciplinary approaches in medical therapeutics may be possibly making new ways of meeting the needs of patients with tinnitus.
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Affiliation(s)
- Kenneth M Grundfast
- Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA
- Otology Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Taylor L Jamil
- Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
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13
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Illg A, Lukaschyk J, Kludt E, Lesinski-Schiedat A, Billinger-Finke M. Do Not Go Gentle into That Deaf Night: A Holistic Perspective on Cochlear Implant Use as Part of Healthy Aging. J Pers Med 2022; 12:1658. [PMID: 36294797 PMCID: PMC9605441 DOI: 10.3390/jpm12101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Research suggests that cochlear implant (CI) use in elderly people improves speech perception and health-related quality of life (HRQOL). CI provision could also prevent dementia and other comorbidities and support healthy aging. The aim of this study was (1) to prospectively investigate potential changes in HRQOL and speech perception and (2) to identify clinical action points to improve CI treatment. Participants (n = 45) were CI recipients aged 60-90 with postlingual deafness. They were divided into groups, according to age: Group 1 (n = 20) received a CI between the age of 60-70 years; group 2 (n = 25) between the age of 71-90 years. HRQOL and speech perception were assessed preoperatively, and three and twelve months postoperatively. HRQOL and speech perception increased significantly within one year postoperatively in both groups. No difference between groups was found. We conclude that CI treatment improves speech perception and HRQOL in elderly users. Improvement of the referral process for CI treatment and a holistic approach when discussing CI treatment in the elderly population could prevent auditory deprivation and the deterioration of cognitive abilities.
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Affiliation(s)
- Angelika Illg
- German Hearing Center, Department of Otorhinolaryngology, Medical University Hannover, Karl-Wiechert-Allee 3, 30625 Hannover, Germany
| | - Julia Lukaschyk
- German Hearing Center, Department of Otorhinolaryngology, Medical University Hannover, Karl-Wiechert-Allee 3, 30625 Hannover, Germany
| | - Eugen Kludt
- German Hearing Center, Department of Otorhinolaryngology, Medical University Hannover, Karl-Wiechert-Allee 3, 30625 Hannover, Germany
| | - Anke Lesinski-Schiedat
- German Hearing Center, Department of Otorhinolaryngology, Medical University Hannover, Karl-Wiechert-Allee 3, 30625 Hannover, Germany
| | - Mareike Billinger-Finke
- German Hearing Center, Department of Otorhinolaryngology, Medical University Hannover, Karl-Wiechert-Allee 3, 30625 Hannover, Germany
- MED-EL GmbH, 6020 Innsbruck, Austria
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Holder JT, Holcomb MA, Snapp H, Labadie RF, Vroegop J, Rocca C, Elgandy MS, Dunn C, Gifford RH. Guidelines for Best Practice in the Audiological Management of Adults Using Bimodal Hearing Configurations. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e011. [PMID: 36274668 PMCID: PMC9581116 DOI: 10.1097/ono.0000000000000011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Clinics are treating a growing number of patients with greater amounts of residual hearing. These patients often benefit from a bimodal hearing configuration in which acoustic input from a hearing aid on 1 ear is combined with electrical stimulation from a cochlear implant on the other ear. The current guidelines aim to review the literature and provide best practice recommendations for the evaluation and treatment of individuals with bilateral sensorineural hearing loss who may benefit from bimodal hearing configurations. Specifically, the guidelines review: benefits of bimodal listening, preoperative and postoperative cochlear implant evaluation and programming, bimodal hearing aid fitting, contralateral routing of signal considerations, bimodal treatment for tinnitus, and aural rehabilitation recommendations.
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Affiliation(s)
| | | | | | | | | | - Christine Rocca
- Guy’s and St. Thomas’ Hearing Implant Centre, London, United Kingdom
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Cochlear Implantation Improves Both Speech Perception and Patient-Reported Outcomes: A Prospective Follow-Up Study of Treatment Benefits among Adult Cochlear Implant Recipients. J Clin Med 2022; 11:jcm11082257. [PMID: 35456353 PMCID: PMC9032498 DOI: 10.3390/jcm11082257] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023] Open
Abstract
Cochlear implantation is considered the best treatment option for patients with severe-to-profound sensorineural hearing loss for whom conventional hearing aids are insufficient. We used a repeated measures longitudinal approach to evaluate speech recognition and patient-reported outcomes after cochlear implantation in an unbiased cohort of Danish adult patients in a prospective cohort study. We assessed 39 recipients before and two times after implantation using a battery of tests that included Dantale I, the Danish Hearing in Noise Test, the Nijmegen Cochlear Implant Questionnaire, and the Speech, Spatial, and Qualities of Hearing Scale. The study group improved significantly on all outcome measures following implantation. On average, Dantale I scores improved by 29 percentage points and Hearing in Noise Test scores improved by 22 percentage points. Most notably, the average Dantale score improved from 26 to 70% in the CI in quiet condition and from 12 to 42% in the cochlear implantation in noise condition when tested monaurally. Dantale demonstrated a significant positive correlation with Nijmegen Cochlear Implant Questionnaire and Speech, Spatial, and Qualities of Hearing Scale scores, while Hearing in Noise Test had no significant correlation with the patient-reported outcome measures. Patients improved significantly at 4 months and marginally improved further at 14 months, indicating that they were approaching a plateau. Our study’s use of audiometric and patient-reported outcome measures provides evidence of the treatment benefits of cochlear implantation in adults, which may help physicians advise patients on treatment decisions and align treatment benefit expectations, as well as serve as a foundation for the development of new cochlear implantation selection criteria.
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Assouly KKS, Dullaart MJ, Stokroos RJ, van Dijk B, Stegeman I, Smit AL. Systematic Review on Intra- and Extracochlear Electrical Stimulation for Tinnitus. Brain Sci 2021; 11:brainsci11111394. [PMID: 34827395 PMCID: PMC8615734 DOI: 10.3390/brainsci11111394] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/08/2021] [Accepted: 10/19/2021] [Indexed: 12/17/2022] Open
Abstract
Several electrical stimulation patterns of the auditory nerve have been described for tinnitus relief, but there is no consensus on the most effective stimulation pattern. Therefore, we aim to systematically review the literature on the effect of intra- and extracochlear electrical stimulation patterns as a treatment option for patients with tinnitus. Only studies on intra- and extracochlear electrical stimulation for patients with tinnitus were included if the stimulation used did not concern standardized CI stimulation patterns to primarily rehabilitate hearing loss as intervention. A total of 34 studies met the inclusion criteria, with 10 studies (89 patients) on intracochlear electrical stimulation and 25 studies on extracochlear electrical stimulation (1109 patients). There was a high to medium risk of bias in 22 studies, especially due to lack of a non-exposed group and poor selection of the exposed group. All included studies showed subjective tinnitus improvement during or after electrical stimulation, using different stimulation patterns. Due to methodological limitations and low reporting quality of the included studies, the potential of intra- and extracochlear stimulation has not been fully explored. To draw conclusions on which stimulation patterns should be optimized for tinnitus relief, a deeper understanding of the mechanisms involved in tinnitus suppression is needed.
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Affiliation(s)
- Kelly K. S. Assouly
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, 3584 Utrecht, The Netherlands; (M.J.D.); (R.J.S.); (I.S.); (A.L.S.)
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
- Cochlear Technology Center, 2800 Mechelen, Belgium;
- Correspondence: ; Tel.: +31-88-755-6644
| | - Max J. Dullaart
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, 3584 Utrecht, The Netherlands; (M.J.D.); (R.J.S.); (I.S.); (A.L.S.)
| | - Robert J. Stokroos
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, 3584 Utrecht, The Netherlands; (M.J.D.); (R.J.S.); (I.S.); (A.L.S.)
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - Bas van Dijk
- Cochlear Technology Center, 2800 Mechelen, Belgium;
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, 3584 Utrecht, The Netherlands; (M.J.D.); (R.J.S.); (I.S.); (A.L.S.)
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, 3584 Utrecht, The Netherlands; (M.J.D.); (R.J.S.); (I.S.); (A.L.S.)
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
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