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Lee SW, Yuen HW, Low D, Kamath S, Chua KWD. The functional impact of implantable hearing devices in patients with single-sided deafness. PROCEEDINGS OF SINGAPORE HEALTHCARE 2023. [DOI: 10.1177/20101058231160604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Introduction Single-sided deafness (SSD) is associated with significant functional impairment such as listening speech in noise and localizing sound. To date, studies on the efficacy of CI and BCI for single-sided deafness are conflicting. Objective Thus, the objective of our study was to describe and compare the functional outcomes between these devices. Methods Thirteen subjects with SSD were prospectively recruited for our study. Six underwent CI and seven received BCI. Word recognition scores (WRS) and disease specific outcome measures were obtained pre-implantation, at 6, and 12 months. Results WRS improved both in quiet and in noise for CI and BCI recipients. On the contrary, CI recipients displayed improvement in Speech Spatial Quality (SSQ) scores. A decreasing trend of improvement in APHAB scores were observed for the BCI group. Conclusion BCI recipients showed a significant improvement in WRS (in noise). Conversely, CI recipients showed a great improvement in SSQ scores. These preliminary findings suggest that true binaural hearing can only be restored with CI for better SSQ performance. However, BCIs could be recommended to a sub-group of patients, if listening to speech in noise is a priority.
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Affiliation(s)
- Sin Wai Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Heng Wai Yuen
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - David Low
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Savitha Kamath
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Kenneth Wei De Chua
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
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Deklerck AN, Swinnen F, Keppler H, Dhooge IJM. Changes in Tinnitus Characteristics and Residual Inhibition following Cochlear Implantation: A Prospective Analysis. Brain Sci 2023; 13:1484. [PMID: 37891851 PMCID: PMC10605020 DOI: 10.3390/brainsci13101484] [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: 09/24/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
This study aims to explore the effect of cochlear implantation on tinnitus perception. A prospective study was conducted on 72 adult hearing-impaired patients to evaluate tinnitus perception before and after cochlear implantation, using standardized tinnitus questionnaires (the tinnitus sample case-history questionnaire, tinnitus functional index (TFI), and tinnitus handicap inventory (THI)). A large variety of demographic and hearing- and implant-related data was collected from patient hospital records to explore possible associations with the implantation effect. The prevalence of tinnitus complaints before implantation was 58.3%. The temporary induction or aggravation of tinnitus immediately after surgery was noted in 20% and 46.7% of patients, respectively. When evaluated 3 months after implantation, 60% of tinnitus patients experienced a clinically significant reduction in their complaints; most of the improvements were experienced immediately after activation of the implant. Only the scores for TFI and THI at baseline were found to be significantly correlated with a reduction in TFI scores after implantation. In 80% of tinnitus patients, the tinnitus remained suppressed for some time after taking off the device. The large subset of patients with residual inhibition supports the involvement of central pathophysiological processes in implantation effects on tinnitus, which are explored in this paper.
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Affiliation(s)
- Ann Nancy Deklerck
- Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Freya Swinnen
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (F.S.); (H.K.)
- Department of Otorhinolaryngology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (F.S.); (H.K.)
- Department of Otorhinolaryngology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Ingeborg Johanna Maria Dhooge
- Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
- Department of Otorhinolaryngology, Ghent University Hospital, 9000 Ghent, Belgium
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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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Assouly KKS, Arts RAGJ, Graham PL, van Dijk B, James CJ. Influence of tinnitus annoyance on hearing-related quality of life in cochlear implant recipients. Sci Rep 2022; 12:14423. [PMID: 36002556 PMCID: PMC9402917 DOI: 10.1038/s41598-022-18823-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/19/2022] [Indexed: 01/10/2023] Open
Abstract
Tinnitus is a common symptom in cochlear implant (CI) recipients. There is no clear evidence of the influence of tinnitus on hearing-related quality of life (QoL) in this population. The aim of this study was to assess the relationship between hearing-related QoL measured by the Speech, Spatial and Qualities of Hearing scale (SSQ12) and tinnitus annoyance or perceived change in tinnitus annoyance after cochlear implantation. The study sample consisted of 2322 implanted adults across France, Germany, Ireland, Italy, the Netherlands, Sweden and the United Kingdom. Information relating to QoL measured using the SSQ12 and tinnitus annoyance and change in tinnitus annoyance, assessed using single-item questions, were collected one or more years post-implantation. The relationship between SSQ12 score and tinnitus annoyance or change in tinnitus annoyance was analysed using linear models adjusted for age and unilateral versus bilateral implants. Tukey pairwise tests were used to compare mean SSQ12 scores across levels of tinnitus annoyance and changes. Tinnitus prevalence was 33.9% post-implantation. Recipients with tinnitus had a significantly lower SSQ12 score than recipients without tinnitus. SSQ scores varied significantly with tinnitus annoyance, age and unilateral versus bilateral implants. Overall, CI recipients who experienced less bothersome tinnitus reported better hearing-related QoL. Healthcare professionals should be aware of the influence of tinnitus on CI recipients’ hearing to manage patient expectations.
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Affiliation(s)
- Kelly K S Assouly
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. .,University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands. .,Cochlear Technology Centre Belgium, Mechelen, Belgium.
| | | | - Petra L Graham
- School of Mathematical and Physical Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Bas van Dijk
- Cochlear Technology Centre Belgium, Mechelen, Belgium
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Evaluating the Revised Work Rehabilitation Questionnaire in Cochlear Implant Users Cochlear Implant Outcome Assessment Based on the International Classification of Functioning, Disability, and Health (ICF). Otol Neurotol 2022; 43:e571-e577. [PMID: 35283464 DOI: 10.1097/mao.0000000000003524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The 59-item Work Rehabilitation Questionnaire (WORQ) was developed based on the International Classification of Functioning, Disability and Health (ICF) core set for vocational rehabilitation to assess work related functioning. It was revised to include 17 questions, assigned to 14 ICF categories relevant to cochlear implant (CI) users. This cross-sectional multicenter study aimed to evaluate CI users' responses on the WORQ questions to describe and generate ICF qualifiers for the revised WORQ in CI users, forming part of a broader framework of CI outcome measures linked to the ICF. METHODS One hundred seventy-seven adults over the age of 18 years with a minimum of one year's device experience were included in the analysis. The WORQ was completed by the participants at a routine visit to the clinic, via email, or via post. RESULTS Most of the CI users perceived no problem on the WORQ questions (53.7%-91%), finished secondary school (54.2%) or obtained a college or university degree (32.8%) and are either employed (41.2%) or retired (34.5%). CI users that are currently working mostly have a full-time position (34.5%). Subjects reported no problem (91%) with sensation of falling, while handling communication devices and techniques (10.9%) and tinnitus (9.6%) showed the highest number of subjects reporting a complete problem. CONCLUSIONS Overall, most of the CI users experienced no impairment, restriction or limitation on the WORQ questions and their assigned ICF categories. Their education level resembles the education level of the general population and they seem to integrate or reintegrate well in professional life postoperatively.
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Chen SL, Chan KC, Hu CY, Fang HY, Wu CM. Experience of adult cochlear implantation at a tertiary hospital. J Chin Med Assoc 2022; 85:469-477. [PMID: 35019869 DOI: 10.1097/jcma.0000000000000690] [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: 11/26/2022] Open
Abstract
BACKGROUND The prevalence of adult cochlear implant (CI) surgery is increasing. However, the relevant adult CI data in Taiwan are insufficient due to the relatively small number of adult implant patients. The two main factors hindering adult implantation are the high cost of the surgery itself and inadequate knowledge regarding the effectiveness of CI for hearing and suppression of tinnitus. Here, we present data regarding adult CI outcomes from a single tertiary hospital. METHODS A total of 116 consecutive adult CI recipients (≥18 years old) who completed at least 12 months of speech perception tests (words and sentences) between January 1999 and December 2020 were enrolled in this retrospective population-based cohort study. Thirty patients completed speech perception (words and sentences) testing as well as three questionnaires relating to quality of life, and 71 completed full tinnitus suppression studies. Subjects' pre- and post-CI questionnaires were evaluated to assess overall CI outcome. RESULTS For auditory evaluation, the scores of easy sentences (ES), difficult sentences (DS), and phonetically balanced (PB) word recognition tests reached a plateau at 3 months post-CI (p = 0.005, 0.001, and 0.004, respectively) in most subjects. The post-CI scores of bodily pain, mental health, and social role functioning were significantly higher than corresponding pre-CI scores on the SF-36 Health Survey-Taiwan version (p = 0.036, 0.019, and 0.002, respectively). Furthermore, the post-CI scores of basic sound perception, speech production, and advanced sound perception were significantly higher than the corresponding pre-CI scores on the Nijmegen Cochlear Implant Questionnaire (p < 0.001, 0.013, and <0.001, respectively). Self-esteem was significantly correlated with the Categories of Auditory Performance scale and Speech Intelligibility Rating scale at 3, 6, and 9 months post-CI. CI improved tinnitus in approximately 65.1% of 71 adults. Based on the Tinnitus Handicap Inventory, 66.7% of patients were in grade 3-5 before surgery. However, after CI, only 34.4% of patients remained in THI grade 3-5. CONCLUSION This study confirmed that CI can improve speech perception (words and sentences), physical health, mental health, social interaction, and self-esteem in adult patients with profound hearing loss. CI also significantly alleviated tinnitus. The outcomes of ES, DS, and PB tests at 3 months post-CI were non-inferior to other longer post-CI periods and could be utilized as references for recovery and evaluation of prognosis.
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Affiliation(s)
- Shih-Lung Chen
- Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan, ROC
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Kai-Chieh Chan
- Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan, ROC
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chih-Yu Hu
- Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan, ROC
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Hsuan-Yeh Fang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Otorhinolaryngology & Head and Neck Surgery, Hsinchu Mackey Memorial Hospital, Hsinchu, Taiwan, ROC
| | - Che-Ming Wu
- Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan, ROC
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Otorhinolaryngology & Head and Neck Surgery, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan, ROC
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明 静, 胡 金, 韦 冰. [Tinnitus and depression after cochlear implantation in adult sensorineural deafness]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:86-89. [PMID: 35172542 PMCID: PMC10128313 DOI: 10.13201/j.issn.2096-7993.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Indexed: 06/14/2023]
Abstract
Objective:The aim of this study is to investigate the changes and correlation of tinnitus and depression in adult patients with severe deafness after cochlear implantation. Methods:A total of 166 adult patients who underwent cochlear implantation(CI) were retrospectively selected as the research objects. All patients were investigated by Chinese Version of the Tinnitus Handicap Inventory(THI-C) and Chinese Version of the Beck Depression Inventory-Ⅱ(BDI-Ⅱ-C) before and after operation, and the improvement of tinnitus after operation was observed THI-C and BDI-Ⅱ-C scores before and after operation and the correlation between them. Results:Re-examination at 6 months after CI showed that the evaluation grade of tinnitus disability before and after the operation decreased significantly(Z=-9.478, P<0.001), and the THI-C score (t=69.128, P<0.001), and BDI-Ⅱ-C score (t=58.531,P<0.01)were significantly reduced. Spearman correlation analysis showed that there was a significant positive correlation between THI-C and BDI-Ⅱ-C scores before and after operation, aswell as the improvement of THI-C score and BDI-Ⅱ-C score(rpreoperative=0.763, rpostoperative=0.741, rdifference=0.741, all P<0.001). Conclusion:Cochlear implantation can significantly improve tinnitus and depression in adult patients with sensorineural hearing loss. With the improvement of tinnitus, the depressive state of patients can be alleviated accordingly.
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Affiliation(s)
- 静 明
- 安徽省第二人民医院耳鼻咽喉头颈外科(合肥,230012)Department of Otolaryngology Head and Neck Surgery of Anhui Second People's Hospital, Hefei, 230012, China
| | - 金旺 胡
- 安徽省第二人民医院耳鼻咽喉头颈外科(合肥,230012)Department of Otolaryngology Head and Neck Surgery of Anhui Second People's Hospital, Hefei, 230012, China
| | - 冰雪 韦
- 安徽省第二人民医院耳鼻咽喉头颈外科(合肥,230012)Department of Otolaryngology Head and Neck Surgery of Anhui Second People's Hospital, Hefei, 230012, China
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Yuen E, Ma C, Nguyen SA, Meyer TA, Lambert PR. The Effect of Cochlear Implantation on Tinnitus and Quality of Life: A Systematic Review and Meta-analysis. Otol Neurotol 2021; 42:1113-1122. [PMID: 33973951 DOI: 10.1097/mao.0000000000003172] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To ascertain the effect of cochlear implantation (CI) on tinnitus and quality of life. DATABASES SOURCES PubMed, Scopus, Web of Science, and Cochrane Library were searched through August 21, 2020. Search strategies used a combination of subject headings (e.g., MeSH in PubMed) and keywords for the following two concepts: cochlear implantation and tinnitus. STUDY SELECTION English articles reporting on pre-intervention tinnitus-related patient-reported outcome measures (e.g., Tinnitus Handicap Inventory [THI], Tinnitus Questionnaire [TQ], Visual Analogue Scale [VAS] for loudness) and quality of life measures (e.g., Nijmegen Cochlear Implantation Questionnaire [NCIQ] and Hospital Anxiety and Depression Scale [HADS]) for CI recipients were included. DATA EXTRACTION Demographics, baseline, and follow-up data. DATA SYNTHESIS Total of 27 articles reporting on 1,285 patients (mean age 54.5 years, range 14-81) were included. Meta-analysis of all tinnitus-related measures demonstrated improvement following implantation, with a mean difference of -23.2 [95% CI: -28.8 to -17.7], -12.6 [95% CI: -17.5 to -7.8], and -4.5 [95% CI: -5.5 to -3.4] (p < 0.05 for all) for THI, TQ, and VAS, respectively. NCIQ increased by 12.2 points [95% CI: 8.2-16.2] (p < 0.05), indicating improved quality of life among CI recipients. Psychological comorbidities were also ameliorated, as evidenced by reductions in HADS depression (-1.7 [95% CI: -2.4 to -0.9]) and anxiety (-1.3 [95% CI: -2.1 to -0.5]) (p < 0.05 for both) scores. CONCLUSION Following CI, patients reported significant improvement in tinnitus via several validated questionnaires. Additional benefits include improved quality of life and reduction in psychological comorbidities.
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Affiliation(s)
- Erick Yuen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Villavisanis DF, Mavrommatis MA, Berson ER, Bellaire CP, Rutland JW, Fan CJ, Wanna GB, Cosetti MK. Cochlear Implantation in Meniere's Disease: A Systematic Review and Meta-Analysis. Laryngoscope 2021; 131:1845-1854. [PMID: 33464598 DOI: 10.1002/lary.29393] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/23/2020] [Accepted: 01/02/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES/HYPOTHESIS Meniere's disease (MD) is a debilitating condition characterized by hearing loss, vertigo, and tinnitus. The objective of this study was to systematically investigate outcomes in MD after cochlear implantation (CoI), with and without labyrinthectomy. STUDY DESIGN Systematic review and meta-analysis. METHODS A systematic review of articles in Medline and Embase was performed to identify all studies of patients with MD who underwent CoI. This analysis evaluates outcomes of speech recognition, pure tone audiometry, vertigo, tinnitus, and quality of life. RESULTS Of 321 studies identified, 37 were included, involving 216 patients. Mean age at implantation was 61.4 years (range 27-85 years) with average length of follow-up at 1.7 years (range 0-9 years). Forty-four (20.4%) patients underwent labyrinthectomy. Meta-analysis demonstrated significant improvements in audiometric outcomes following CoI. There was a statistically significant improvement in Hearing in Noise Test performance, with a mean difference improvement of 44.7 (95% confidence interval [CI] [8.8, 80.6]) at 6 months and 60.1 (95% CI [35.3, 85.0]) at 12 months. The Freiburger Monosyllabic Test (FMT) and Consonant-Nucleus-Consonant (CNC) also improved significantly, with mean difference improvements of 46.2 (95% CI [30.0, 62.4]) for FMT and 19.3 (95% CI [8.1, 30.4]) for CNC. There was a statistically significant decrease in tinnitus, as measured by a mean difference reduction of 48.1 (95% CI [1.0, 95.2]) in the Tinnitus Handicap Index. CONCLUSIONS CoI with and without simultaneous labyrinthectomy is a viable treatment option for patients with MD, yielding high rates of tinnitus suppression and vertigo control. Post-CoI MD patients demonstrate similar postoperative speech perception outcomes to non-MD implant recipients. Laryngoscope, 131:1845-1854, 2021.
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Affiliation(s)
- Dillan F Villavisanis
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Maria A Mavrommatis
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Elisa R Berson
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, U.S.A
| | - Christopher P Bellaire
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - John W Rutland
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Caleb J Fan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Maura K Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
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Duchêne J, Ribadeau Dumas A, Bonnard D, Sagardoy T, Franco-Vidal V. Musical Ear Syndrome: Prevalence and characteristics in cochlear implant bearers. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:153-157. [PMID: 33257264 DOI: 10.1016/j.anorl.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Musical Ear Syndrome (MES) is an uncommon phenomenon described as the perception of auditory musical sensations not corresponding to any external stimulus. It seems to be more frequent in case of profound hearing loss. Our objective was to evaluate prevalence, characteristics and risk factors in a population of cochlear implant patients. METHODS A retrospective study was conducted in cochlear implant patients, who were adult (>18 years) in 2020 and underwent cochlear implantation between 1993 and 2019. We analyzed the presence and characteristics of MES. RESULTS 118 of the 358 patients (33%) perceived or had perceived auditory musical sensations: 71 (19.8%) before, 100 (28%) after, and 53 (14.8%) both before and after implantation. The musical auditory sensations were usually short and well-tolerated, resembling instrumental music, and occurring several times a day. Thirteen patients (11%) considered them intolerable. Fatigue was a triggering factor in 40 patients (33.9%). Personal and medical characteristics, type of implantation, make of implant, etiology and tinnitus did not emerge as risk factors. On the other hand, MES+ patients were significatively younger (56±17.4 years versus 61.9±17.9 years; P=0.0009). Despite the phenomenon, patients were satisfied with implant functioning and subjective auditory performance was not affected. CONCLUSION Prevalence of Musical Ear Syndrome was high in cochlear implant patients, and especially in younger subjects. It is essential to improve knowledge of this phenomenon.
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Affiliation(s)
- J Duchêne
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France.
| | - A Ribadeau Dumas
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - D Bonnard
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - T Sagardoy
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - V Franco-Vidal
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
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Smith SS, Kitterick PT, Scutt P, Baguley DM, Pierzycki RH. An exploration of psychological symptom-based phenotyping of adult cochlear implant users with and without tinnitus using a machine learning approach. PROGRESS IN BRAIN RESEARCH 2020; 260:283-300. [PMID: 33637224 DOI: 10.1016/bs.pbr.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The identification of phenotypes within populations with troublesome tinnitus is an important step towards individualizing tinnitus treatments to achieve optimal outcomes. However, previous application of clustering algorithms has called into question the existence of distinct tinnitus-related phenotypes. In this study, we attempted to characterize patients' symptom-based phenotypes as subpopulations in a Gaussian mixture model (GMM), and subsequently performed a comparison with tinnitus reporting. We were able to effectively evaluate the statistical models using cross-validation to establish the number of phenotypes in the cohort, or a lack thereof. We examined a cohort of adult cochlear implant (CI) users, a patient group for which a relation between psychological symptoms (anxiety, depression, or insomnia) and trouble tinnitus has previously been shown. Accordingly, individual item scores on the Hospital Anxiety and Depression Scale (HADS; 14 items) and the Insomnia Severity Index (ISI; 7 items) were selected as features for training the GMM. The resulting model indicated four symptom-based subpopulations, some primarily linked to one major symptom (e.g., anxiety), and others linked to varying severity across all three symptoms. The presence of tinnitus was self-reported and tinnitus-related handicap was characterized using the Tinnitus Handicap Inventory. Specific symptom profiles were found to be significantly associated with CI users' tinnitus characteristics. GMMs are a promising machine learning tool for identifying psychological symptom-based phenotypes, which may be relevant to determining appropriate tinnitus treatment.
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Affiliation(s)
- Samuel S Smith
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
| | - Pádraig T Kitterick
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, Nottingham, United Kingdom; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, United Kingdom
| | - Polly Scutt
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, Nottingham, United Kingdom
| | - David M Baguley
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, Nottingham, United Kingdom; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, United Kingdom
| | - Robert H Pierzycki
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, Nottingham, United Kingdom
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Opperman E, le Roux T, Masenge A, Eikelboom RH. The effect of tinnitus on hearing-related quality of life outcomes in adult cochlear implant recipients. Int J Audiol 2020; 60:246-254. [PMID: 33100038 DOI: 10.1080/14992027.2020.1828633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe the effect of tinnitus distress on the hearing-related quality of life (QoL) outcomes over time in adult cochlear implant (CI) recipients. DESIGN A retrospective, longitudinal study of adult CI recipients was conducted. Hearing-related QoL and tinnitus distress were assessed using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Tinnitus Reaction Questionnaire (TRQ) preoperatively and at 6-months, 12-months and >24-month postoperatively. The association between tinnitus distress and hearing-related QoL outcomes over time was investigated. Furthermore, 13 potential predictive factors were identified from the retrospective dataset. Multiple regression analyses were performed to identify variables that influence hearing-related QoL outcomes over time. STUDY SAMPLE The study sample included 210 adult (≥18 years) CI recipients implanted between 2001 and 2017. RESULTS Lower tinnitus distress and younger age at implantation were significant predictors of better hearing-related QoL in adult CI recipients. A significant reduction in tinnitus distress up to two years post-implantation was found, as well as greater tinnitus distress correlating with poorer hearing-related QoL outcomes. CONCLUSION Tinnitus distress negatively affects the hearing-related QoL outcomes of adult CI recipients. Tinnitus distress and age at implantation were found to be significant predictors of hearing-related QoL when controlling for other predictive factors.
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Affiliation(s)
- Elmien Opperman
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa
| | - Andries Masenge
- Department of Statistics, University of Pretoria, Hatfield, South Africa
| | - Robert H Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa.,Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
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13
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Sarac ET, Ozbal Batuk M, Batuk IT, Okuyucu S. Effects of Cochlear Implantation on Tinnitus and Depression. ORL J Otorhinolaryngol Relat Spec 2020; 82:209-215. [PMID: 32594084 DOI: 10.1159/000508137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Tinnitus is prevalent in 66-88% of cochlear implant users. The reason for this high prevalence is that hearing impairment is the most common cause of tinnitus. OBJECTIVE This study aims to determine the effect of cochlear implant and to compare the severity of tinnitus and depression in adult cochlear implant users with tinnitus. METHODS Patients diagnosed with tinnitus filled out the Tinnitus Handicap Inventory and the Beck Depression Inventory during CI candidate evaluation. The audiological follow-up in the present study included only patients suffering from tinnitus before the cochlear implant surgery. This study included only patients who had tinnitus handicap inventory and Beck Depression Inventory clinical records pre- and postoperatively, including 23 adult cochlear implant users (13 males and 10 females) aged 18-76 years. RESULTS AND CONCLUSION There was a statistically significant decrease in the severity of tinnitus and depression after cochlear implant. As the participants' tinnitus level and grade decreased, their depression levels also decreased. Depression levels decreased after the use of a cochlear implant compared to before cochlear implantation. Cochlear implantation is currently used only for hearing restoration. However, cochlear implantation may be used in rehabilitation for tinnitus in patients with severe hearing loss and in tinnitus patients. In addition cochlear implantation can be a depression rehabilitation method by reducing tinnitus.
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Affiliation(s)
- Elif Tugba Sarac
- Ear-Nose-Throat-Audiology Department, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey,
| | - Merve Ozbal Batuk
- Audiology Department, Faculty of Health Science, Hacettepe University, Ankara, Turkey
| | - Isa Tuncay Batuk
- Audiology Department, Faculty of Health Science, Hacettepe University, Ankara, Turkey
| | - Semsettin Okuyucu
- Ear-Nose-Throat Department, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
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Abstract
OBJECTIVE Determine the prevalence of clinical insomnia and its associations with anxiety, depression, and tinnitus in adult cochlear implant (CI) users. DESIGN Self-reported information on tinnitus, sleep, and demographic variables was collected from adult CI users (n = 127). Tinnitus presence, its persistence, related emotional distress, and difficulties with sleep were assessed using questions from the UK Biobank study (www.ukbiobank.ac.uk). Tinnitus-related handicap was assessed using the Tinnitus Handicap Inventory. Clinical insomnia symptoms were characterized using the Insomnia Severity Index (ISI), and clinical anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS). Regression models were used to compare the data from CI users with and without tinnitus, and to test the associations between clinical insomnia, anxiety, depression and tinnitus handicap. RESULTS About a half (53%) of CI users reported tinnitus, of whom 54% described it as persistent, 41% as emotionally distressing and 73% reported having difficulties with sleep based on the UK Biobank questions. The ISI suggested that clinically abnormal insomnia symptoms were more likely to occur with tinnitus (odds ratio [OR] = 2.60, 95% confidence interval 1.04 to 6.45; p = 0.040) and were found in 41% of CI users with tinnitus. Post-hoc exploratory analyses on the ISI suggested that CI users with tinnitus experienced greater levels of difficulty falling asleep, lower satisfaction with sleep patterns, greater interference of sleep problems with daily activities, and a greater impact on their quality of life. The HADS scores suggested that those with tinnitus were also more likely to have clinically abnormal anxiety (42%; OR = 3.50, 95% confidence interval 1.49 to 8.22; p = 0.004) and depression symptoms (14%; OR = 6.18, 95% confidence interval 1.17 to 32.82; p = 0.032). The clinical insomnia observed in CI users with tinnitus was associated with tinnitus handicap (p = 0.028), and the levels of clinical anxiety (p = 0.012) and depression (p < 0.001). CONCLUSIONS Clinically abnormal insomnia symptoms are prevalent, potentially affecting over 40% of CI users with tinnitus. The associations between clinical insomnia, anxiety, and depression symptoms, and tinnitus-related handicap suggest that all of these symptoms should be considered when assessing the tinnitus-related burden and its impact on the quality of life after cochlear implantation. The present findings also have potential implications for the clinical management of CI recipients with tinnitus, in whom it may be advisable to monitor sleep problems so that they can be addressed where appropriate. Further research is needed to investigate the mechanisms and causal links behind insomnia and tinnitus-related symptoms in this population. Future studies should also investigate the feasibility and effectiveness of night time use of CIs to alleviate tinnitus-related insomnia. The potential impact of insomnia on the quality of life of CI users with tinnitus highlights the importance of including sleep measures in future evaluations of the effectiveness of cochlear implantation for the alleviation of tinnitus.
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Niemann U, Boecking B, Brueggemann P, Mazurek B, Spiliopoulou M. Gender-Specific Differences in Patients With Chronic Tinnitus-Baseline Characteristics and Treatment Effects. Front Neurosci 2020; 14:487. [PMID: 32523506 PMCID: PMC7261931 DOI: 10.3389/fnins.2020.00487] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/20/2020] [Indexed: 11/29/2022] Open
Abstract
Whilst some studies have identified gender-specific differences, there is no consensus about gender-specific determinants for prevalence rates or concomitant symptoms of chronic tinnitus such as depression or anxiety. However, gender-associated differences in psychological response profiles and coping strategies may differentially affect tinnitus chronification and treatment success rates. Thus, understanding gender-associated differences may facilitate a more detailed identification of symptom profiles, heighten treatment response rates, and help to create access for vulnerable populations that are potentially less visible in clinical settings. Our research questions are: RQ1: how do male and female tinnitus patients differ regarding tinnitus-related distress, depression severity, and treatment response, RQ2: to what extent are answers to questionnaires administered at baseline associated with gender, and RQ3: which baseline questionnaire items are associated with tinnitus distress, depression, and treatment response, while relating to one gender only? In this work, we present a data analysis workflow to investigate gender-specific differences in N = 1,628 patients with chronic tinnitus (828 female, 800 male) who completed a 7-day multimodal treatment encompassing cognitive behavioral therapy (CBT), physiotherapy, auditory attention training, and information counseling components. For this purpose, we extracted 181 variables from 7 self-report questionnaires on socio-demographics, tinnitus-related distress, tinnitus frequency, loudness, localization, and quality as well as physical and mental health status. Our workflow comprises (i) training machine learning models, (ii) a comprehensive evaluation including hyperparameter optimization, and (iii) post-learning steps to identify predictive variables. We found that female patients reported higher levels of tinnitus-related distress, depression and response to treatment (RQ1). Female patients indicated higher levels of tension, stress, and psychological coping strategies rates. By contrast, male patients reported higher levels of bodily pain associated with chronic tinnitus whilst judging their overall health as better (RQ2). Variables measuring depression, sleep problems, tinnitus frequency, and loudness were associated with tinnitus-related distress in both genders and indicators of mental health and subjective stress were found to be associated with depression in both genders (RQ3). Our results suggest that gender-associated differences in symptomatology and treatment response profiles suggest clinical and conceptual needs for differential diagnostics, case conceptualization and treatment pathways.
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Affiliation(s)
- Uli Niemann
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Petra Brueggemann
- Tinnitus Center, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Myra Spiliopoulou
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
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16
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Shoham N, Lewis G, Favarato G, Cooper C. Prevalence of anxiety disorders and symptoms in people with hearing impairment: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2019; 54:649-660. [PMID: 30547211 DOI: 10.1007/s00127-018-1638-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Anxiety disorders are common. Prevalence is likely to be raised in people with hearing impairment, who experience higher rates of associated risk factors. We conducted, to our knowledge, the first systematic review of the prevalence and correlates of anxiety in people with hearing impairment. METHODS We searched electronic databases and references of included studies, using predetermined criteria to retrieve original research reporting prevalence of anxiety disorders or symptoms in adult, hearing impaired populations. We assessed risk of bias using the adapted Newcastle Ottawa Scale. RESULTS We included 25 studies evaluating 17,135 people with hearing impairment. Community studies of higher quality reported a lifetime prevalence of anxiety disorder of 11.1% (one study) and point prevalences of 15.4-31.3% for clinically significant anxiety symptoms (five studies) in people who predominantly had acquired hearing impairment. Anxiety prevalence was higher in hearing impaired people in 8/10 studies with a comparator non-hearing impaired group. Anxiety symptoms decreased after surgical intervention for hearing in all studies investigating this. Correlates consistently associated with anxiety were tinnitus and hearing impairment severity. CONCLUSIONS Prevalence of anxiety is higher among people with hearing impairment than the general population; our findings indicate that this excess morbidity may be related to the hearing impairment itself, as it was associated with the severity of impairment, and reduced after surgical treatment. Clinicians should be aware of the potential impact of hearing on mental health, and that where hearing ability can be improved, this may reduce anxiety. PROSPERO REGISTRATION NUMBER CRD42018088463.
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Affiliation(s)
- Natalie Shoham
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7BN, UK.
| | - Gemma Lewis
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7BN, UK
| | - Graziella Favarato
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7BN, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7BN, UK
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Kloostra F, Verbist J, Hofman R, Free R, Arnold R, van Dijk P. A Prospective Study of the Effect of Cochlear Implantation on Tinnitus. Audiol Neurootol 2019; 23:356-363. [DOI: 10.1159/000495132] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 10/31/2018] [Indexed: 11/19/2022] Open
Abstract
Previous studies have shown diverse and sometimes even contrary results concerning the effect of cochlear implantation on tinnitus and the factors that can influence this effect. The aim of this prospective questionnaire study was to determine the effects of cochlear implantation on tinnitus and explore which factors can influence the effect of cochlear implantation on tinnitus. Forty-four of the patients implanted in our hospital returned 2 questionnaire packages, i.e., one before the cochlear implantation and one 6 months after implantation. Before implantation, 66% of the patients experienced tinnitus. This study shows that cochlear implantation could help to reduce tinnitus and the tinnitus handicap in at least 28% of the patients with preoperative tinnitus. In 72% of the patients the tinnitus remained after implantation. None of the patients developed tinnitus after implantation. A shorter duration of tinnitus prior to implantation, a more fluctuating type of tinnitus, a higher tinnitus handicap prior to implantation, and a round-window surgical approach might have a positive influence on the effect of cochlear implantation on tinnitus, but further research is necessary to confirm these findings.
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18
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Kloostra FJJ, Arnold R, Hofman R, Burgerhof JGM, van Dijk P. Models to predict positive and negative effects of cochlear implantation on tinnitus. Laryngoscope Investig Otolaryngol 2018; 4:138-142. [PMID: 30828631 PMCID: PMC6383300 DOI: 10.1002/lio2.224] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 09/21/2018] [Accepted: 09/28/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives The effect of cochlear implantation on tinnitus is heterogeneous: implantation does not always reduce tinnitus and may even worsen tinnitus. Therefore, it is important to know which factors influence the consequences of cochlear implantation for tinnitus. To date, no consensus has been reached regarding the factors that influence tinnitus. This study aimed to create prognostic models, using binary logistic regression analyses to predict positive or negative changes in tinnitus after cochlear implantation. Methods For this study we retrospectively sent two questionnaire packages to 117 cochlear implant patients. Results In the binary logistic regression analyses of the responses to the questionnaires, it was not possible to create a significant model to predict a positive effect of cochlear implantation on tinnitus. However, a negative effect of cochlear implantation on tinnitus was predictable, using a backward stepwise selection method in a model including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Tinnitus Handicap Questionnaire (THQ) (P < .001, Nagelkerke R2 = 0.529). Conclusions Our results suggest that the lower the preoperative tinnitus handicap and the preoperative hearing handicap, the higher the chance that cochlear implantation will worsen tinnitus. More research needs to be done, preferable in a big prospective study, to make this model instrumental for clinical decision making and preoperative patient counselling. However, our results might suggest that preoperative THQ and APHAB screening could be meaningful. Especially in patients who are afraid to develop tinnitus or tinnitus worsening as complication of cochlear implantation. Level of Evidence 4
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Affiliation(s)
- F J J Kloostra
- Department of Otorhinolaryngology and Head and Neck Surgery University Medical Center Groningen Groningen the Netherlands
| | - R Arnold
- Department of Otorhinolaryngology and Head and Neck Surgery University Medical Center Groningen Groningen the Netherlands
| | - R Hofman
- Department of Otorhinolaryngology and Head and Neck Surgery University Medical Center Groningen Groningen the Netherlands
| | - J G M Burgerhof
- Department of Epidemiology University Medical Center Groningen Groningen the Netherlands
| | - P van Dijk
- Department of Otorhinolaryngology and Head and Neck Surgery University Medical Center Groningen Groningen the Netherlands
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Matsuzaki S, Oishi N, Ogawa K. Severe tinnitus in a patient with acquired deafness for over 50 years: a case report. Biopsychosoc Med 2018; 12:17. [PMID: 30534194 PMCID: PMC6260884 DOI: 10.1186/s13030-018-0136-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background There have been many reports on the treatment effect of cochlear implantation and hearing aids in the treatment of tinnitus in patients with severe hearing loss. However, as far as we are aware, there are no reports of investigation of treatment approaches for the tinnitus of deaf patients whose communication is solely carried out in sign language due to a long duration of deafness. Case presentation We experienced a case of severe tinnitus with bilateral deafness for more than 50 years. The patient is a 69-year-old woman who communicates with her family solely in sign language. Family stress triggered the onset of tinnitus, accompanied by sleep disorder and palpitations. At the initial visit, she suffered from severe tinnitus (THI 94) as well as strong tendencies toward depression and anxiety. Because neither the patient nor her family was willing to use cochlear implantation, the administration of an antidepressant and a sleep-inducing agent was started, which resulted in improvement of the psychological conditions. Tinnitus distress, synchronized with the heartbeat, was relieved by the addition of autogenic training. At four and half years after the initial visit, the THI score had dropped to 0, and the subjective tinnitus and palpitation had almost disappeared, with only a low dose of antidepressant necessary. Conclusion A deaf patient with severe tinnitus was successfully treated with drug and psychotherapy.
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Affiliation(s)
- Saeko Matsuzaki
- Department of Otolaryngology, Sanno Hospital, Tokyo, Japan.,2Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35 Shinamomachi, Shinjuku, Tokyo, 1608582 Japan
| | - Naoki Oishi
- 2Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35 Shinamomachi, Shinjuku, Tokyo, 1608582 Japan
| | - Kaoru Ogawa
- 2Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35 Shinamomachi, Shinjuku, Tokyo, 1608582 Japan
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20
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Ramakers GGJ, van Zanten GA, Thomeer HGXM, Stokroos RJ, Heymans MW, Stegeman I. Development and internal validation of a multivariable prediction model for tinnitus recovery following unilateral cochlear implantation: a cross-sectional retrospective study. BMJ Open 2018; 8:e021068. [PMID: 29895652 PMCID: PMC6009556 DOI: 10.1136/bmjopen-2017-021068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To develop and internally validate a prediction model for tinnitus recovery following unilateral cochlear implantation. DESIGN A cross-sectional retrospective study. SETTING A questionnaire concerning tinnitus was sent to patients with bilateral severe to profound hearing loss, who underwent unilateral cochlear implantation at the University Medical Center Utrecht, the Netherlands, between 1 January 2006 and 31 December 2015. PARTICIPANTS Of 137 included patients, 87 patients experienced tinnitus preoperatively. Data of these 87 patients were used to develop the prediction model. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome of the prediction model was tinnitus recovery. Investigated predictors were: age, gender, duration of deafness, preoperative hearing performance, tinnitus duration, severity and localisation, follow-up duration, localisation of cochlear implant (CI) compared with tinnitus side, surgical approach, insertion depth of the electrode, CI brand and difference in hearing threshold following cochlear implantation. Multivariable backward logistic regression was performed. Missing data were handled using multiple imputation. The performance of the model was assessed by the calibrative and discriminative ability of the model. The prediction model was internally validated using bootstrapping techniques. RESULTS The tinnitus recovery rate was 40%. A lower preoperative Consonant-Vowel-Consonant (CVC) score, unilateral localisation of tinnitus and larger deterioration of residual hearing at 250 Hz revealed to be relevant predictors for tinnitus recovery. The area under the receiver operating characteristics curve (AUC) of the initial model was 0.722 (IQR: 0.703-0.729). After internal validation of this prediction model, the AUC decreased to 0.696 (IQR: 0.667-0.700). CONCLUSION AND RELEVANCE Lower preoperative CVC score, unilateral localisation of tinnitus and larger deterioration of residual hearing at 250 Hz were significant predictors for tinnitus recovery following unilateral cochlear implantation. The performance of the model developed in this retrospective study is promising. However, before clinical use of the model, the conduction of a larger prospective study is recommended.
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Affiliation(s)
- Geerte G J Ramakers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gijsbert A van Zanten
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans G X M Thomeer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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Onishi ET, Coelho CCDB, Oiticica J, Figueiredo RR, Guimarães RDCC, Sanchez TG, Gürtler AL, Venosa AR, Sampaio ALL, Azevedo AA, Pires APBDÁ, Barros BBDC, Oliveira CACPD, Saba C, Yonamine FK, Medeiros ÍRTD, Rosito LPS, Rates MJA, Kii MA, Fávero ML, Santos MADO, Person OC, Ciminelli P, Marcondes RDA, Moreira RKDP, Torres SDMS. Tinnitus and sound intolerance: evidence and experience of a Brazilian group. Braz J Otorhinolaryngol 2018; 84:135-149. [PMID: 29339026 PMCID: PMC9449167 DOI: 10.1016/j.bjorl.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 12/07/2017] [Indexed: 12/13/2022] Open
Abstract
Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience.
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Ramakers GGJ, Kraaijenga VJC, Smulders YE, van Zon A, Stegeman I, Stokroos RJ, Free RH, Frijns JHM, Huinck WJ, Van Zanten GA, Grolman W. Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation. Front Surg 2017; 4:65. [PMID: 29167796 PMCID: PMC5682406 DOI: 10.3389/fsurg.2017.00065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/31/2017] [Indexed: 11/13/2022] Open
Abstract
Importance There is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus. Objective To investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years). Study design This study is a secondary analysis as part of a multicenter randomized controlled trial. Methods Thirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs) because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ). Results The prevalence of preoperative tinnitus was 42% (16/38). One year after bilateral implantation, there was a median difference of -8 (inter-quartile range (IQR): -28 to 4) in THI score and -9 (IQR: -17 to -9) in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group, four patients had an additional benefit of the second CI: a total suppression of tinnitus compared with their unilateral situation. Conclusion While bilateral cochlear implantation can have a positive effect on preoperative tinnitus complaints, the induction of (temporary or permanent) tinnitus was also reported. Clinical Trial Registration Dutch Trial Register NTR1722.
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Affiliation(s)
- Geerte G J Ramakers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Véronique J C Kraaijenga
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Yvette E Smulders
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Alice van Zon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Rolien H Free
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, Netherlands.,Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University Medical Center Groningen, Groningen, Netherlands
| | - Johan H M Frijns
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Gijsbert A Van Zanten
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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Servais JJ, Hörmann K, Wallhäusser-Franke E. Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study. Front Neurol 2017; 8:60. [PMID: 28326059 PMCID: PMC5339283 DOI: 10.3389/fneur.2017.00060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/10/2017] [Indexed: 11/13/2022] Open
Abstract
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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Affiliation(s)
- Jérôme J Servais
- Department of Otorhinolaryngology, Cochlear Implant Centre, University Medicine Mannheim , Mannheim , Germany
| | - Karl Hörmann
- Department of Otorhinolaryngology, Cochlear Implant Centre, University Medicine Mannheim, Mannheim, Germany; Audiology, Medical Faculty Mannheim, Department of Otorhinolaryngology, Heidelberg University, Mannheim, Germany
| | - Elisabeth Wallhäusser-Franke
- Audiology, Medical Faculty Mannheim, Department of Otorhinolaryngology, Heidelberg University , Mannheim , Germany
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Hesse G. Evidence and evidence gaps in tinnitus therapy. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc04. [PMID: 28025604 PMCID: PMC5169077 DOI: 10.3205/cto000131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A nearly endless number of procedures has been tried and in particular sold for the treatment of tinnitus, unfortunately they have not been evaluated appropriately in an evidence-based way. A causal therapy, omitting the tinnitus still does not exist, actually it cannot exist because of the various mechanisms of its origin. However or perhaps because of that, medical interventions appear and reappear like fashion trends that can never be proven by stable and reliable treatment success. This contribution will discuss and acknowledge all current therapeutic procedures and the existing or non-existing evidence will be assessed. Beside external evidence, the term of evidence also encompasses the internal evidence, i.e. the experience of the treating physician and the patient's needs shall be included. While there is no evidence for nearly all direct procedures that intend modulating or stimulating either the cochlea or specific cervical regions such as the auditory cortex, there are therapeutic procedures that are acknowledged in clinical practice and have achieved at least a certain degree of evidence and generate measurable effect sizes. Those are in particular habituation therapy and psychotherapeutic measures, especially if they are combined with concrete measures for improved audio perception (hearing aids, CI, hearing therapies).
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Affiliation(s)
- Gerhard Hesse
- Tinnitus-Klinik, Bad Arolsen, Germany; University of Witten-Herdecke, Germany
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25
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Smit JV, Janssen MLF, Engelhard M, de Bie RMA, Schuurman PR, Contarino MF, Mosch A, Temel Y, Stokroos RJ. The impact of deep brain stimulation on tinnitus. Surg Neurol Int 2016; 7:S848-S854. [PMID: 27994936 PMCID: PMC5134112 DOI: 10.4103/2152-7806.194156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 05/14/2016] [Indexed: 11/24/2022] Open
Abstract
Background: Tinnitus is a disorder of the nervous system that cannot be adequately treated with current therapies. The effect of neuromodulation induced by deep brain stimulation (DBS) on tinnitus has not been studied well. This study investigated the effect of DBS on tinnitus by use of a multicenter questionnaire study. Methods: Tinnitus was retrospectively assessed prior to DBS and at the current situation (with DBS). From the 685 questionnaires, 443 were returned. A control group was one-to-one matched to DBS patients who had tinnitus before DBS (n = 61). Tinnitus was assessed by the tinnitus handicap inventory (THI) and visual analog scales (VAS) of loudness and burden. Results: The THI decreased significantly during DBS compared to the situation prior to surgery (from 18.9 to 15.1, P < .001), which was only significant for DBS in the subthalamic nucleus (STN). The THI in the control group (36.9 to 35.5, P = 0.50) and other DBS targets did not change. The VAS loudness increased in the control group (5.4 to 6.0 P < .01). Conclusion: DBS might have a modulatory effect on tinnitus. Our study suggests that DBS of the STN may have a beneficial effect on tinnitus, but most likely other nuclei linked to the tinnitus circuitry might be even more effective.
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Affiliation(s)
- Jasper V Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcus L F Janssen
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Malou Engelhard
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rob M A de Bie
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
| | - P Richard Schuurman
- Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria F Contarino
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Arne Mosch
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J Stokroos
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
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27
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Greenberg D, Meerton L, Graham J, Vickers D. Developing an assessment approach for perceptual changes to tinnitus sound characteristics for adult cochlear implant recipients. Int J Audiol 2016; 55:392-404. [PMID: 27146518 DOI: 10.3109/14992027.2016.1172391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the impact of cochlear implantation on tinnitus suppression, characteristics, localization, and duration. DESIGN A cochlear implant (CI) recipient-focused postal questionnaire survey. STUDY SAMPLE The questionnaire was posted, with consent, to 100 adults who had received a unilateral CI at the RNTNEH between 1988 and 1999. All adults spoke English as their first language and were postlingually deafened. Sixty-eight adults (38 female, 29 male, one unspecified) aged 31-80 years (mean 61 years) completed and returned the questionnaire without interview. RESULTS With the processor 'ON', CI recipients experienced total or partial suppression of tinnitus ipsilateral to their CI in 57% of cases, and in 43% where tinnitus was perceived contralateral to the CI. The percentage of CI recipients who experienced high tone tinnitus was reduced from 60% pre-implant to 29% post-implant with the processor 'ON' while pulsatile tinnitus was reduced from 38% pre-implant to 13% post-implant. CIs were also found to reduce the tonal complexity and duration, and change the source localization of tinnitus post-implantation. CONCLUSIONS Perceptual changes to tinnitus can take place post-implantation. Changes can occur within the four categories explored: tinnitus suppression, characteristics, localization, and duration of awareness per day.
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Affiliation(s)
| | - Leah Meerton
- b Royal National Throat , Nose & Ear Hospital , London , UK
| | - John Graham
- b Royal National Throat , Nose & Ear Hospital , London , UK
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Kim DK, Moon IS, Lim HJ, Yoo SY, Heo KW, Bae SC, Moon KR, Lee JJ, Choung YH, Park SN. Prospective, Multicenter Study on Tinnitus Changes after Cochlear Implantation. Audiol Neurootol 2016; 21:165-71. [DOI: 10.1159/000445164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/29/2016] [Indexed: 11/19/2022] Open
Abstract
Objective: To investigate the time course of tinnitus changes in patients receiving cochlear implantation (CI) in a prospective, multicenter setting and to determine related factors. Materials and Methods: A total of 79 adult patients who underwent CI were included in this study. We used the same questionnaires sequentially 5 times. The questionnaires included the Visual Analog Scale (VAS) for tinnitus severity, the Tinnitus Handicap Inventory (THI), Beck's Depression Index (BDI), and the Brief Encounter Psychosocial Instrument (BEPSI) for stress assessment. Results: Tinnitus was present in 59 (74.7%) of the 79 study subjects. After CI, tinnitus was eliminated in 10 patients (25%) and improved in 16 patients (40%) of the 40 patients who completed the final questionnaires, and most of the tinnitus reduction occurred in the early period of CI use. In an analysis of psychological functioning with CI, BDI was reduced significantly after CI. Multiple linear regression analysis revealed that preoperative auditory steady-state response (ASSR), THI, and final BDI score were significantly associated with the changes in tinnitus after CI. Conclusions: Most of the tinnitus reduction occurred within 1 month after CI use, and the changes were significantly associated with THI, ASSR, and BDI scores 6 months after CI. CI is a valuable therapeutic modality in tinnitus of a deafened ear.
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Knopke S, Gräbel S, Förster-Ruhrmann U, Mazurek B, Szczepek AJ, Olze H. Impact of cochlear implantation on quality of life and mental comorbidity in patients aged 80 years. Laryngoscope 2016; 126:2811-2816. [DOI: 10.1002/lary.25993] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/10/2016] [Accepted: 02/29/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Steffen Knopke
- Department of Otorhinolaryngology, Head and Neck Surgery; Campus Virchow-Klinikum, Charité-University Medical Center Berlin; Berlin Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Head and Neck Surgery; Campus Virchow-Klinikum, Charité-University Medical Center Berlin; Berlin Germany
| | - Ulrike Förster-Ruhrmann
- Department of Otorhinolaryngology, Head and Neck Surgery; Campus Virchow-Klinikum, Charité-University Medical Center Berlin; Berlin Germany
| | - Birgit Mazurek
- Tinnitus Center, Campus Charité Mitte; Charité-University Medical Center Berlin; Berlin Germany
| | - Agnieszka J. Szczepek
- Tinnitus Center, Campus Charité Mitte; Charité-University Medical Center Berlin; Berlin Germany
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck Surgery; Campus Virchow-Klinikum, Charité-University Medical Center Berlin; Berlin Germany
- Department of Otorhinolaryngology, Head and Neck Surgery; Charité-University Medical Center Berlin; Berlin Germany
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Arts R, Netz T, Janssen A, George E, Stokroos R. The occurrence of tinnitus after CI surgery in patients with severe hearing loss: A retrospective study. Int J Audiol 2015; 54:910-7. [DOI: 10.3109/14992027.2015.1079930] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tyler RS, Keiner AJ, Walker K, Deshpande AK, Witt S, Killian M, Ji H, Patrick J, Dillier N, van Dijk P, Lai WK, Hansen MR, Gantz B. A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant. Am J Audiol 2015; 24:398-410. [PMID: 26001407 DOI: 10.1044/2015_aja-15-0005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/17/2015] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Background sounds provided by a wearable sound playback device were mixed with the acoustical input picked up by a cochlear implant speech processor in an attempt to suppress tinnitus. METHOD First, patients were allowed to listen to several sounds and to select up to 4 sounds that they thought might be effective. These stimuli were programmed to loop continuously in the wearable playback device. Second, subjects were instructed to use 1 background sound each day on the wearable device, and they sequenced the selected background sounds during a 28-day trial. Patients were instructed to go to a website at the end of each day and rate the loudness and annoyance of the tinnitus as well as the acceptability of the background sound. Patients completed the Tinnitus Primary Function Questionnaire (Tyler, Stocking, Secor, & Slattery, 2014) at the beginning of the trial. RESULTS Results indicated that background sounds were very effective at suppressing tinnitus. There was considerable variability in sounds preferred by the subjects. CONCLUSION The study shows that a background sound mixed with the microphone input can be effective for suppressing tinnitus during daily use of the sound processor in selected cochlear implant users.
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Affiliation(s)
| | | | | | | | | | | | | | - Jim Patrick
- Cochlear Limited, Sydney, New South Wales, Australia
| | | | - Pim van Dijk
- University Medical Center, University of Groningen, the Netherlands
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Ramakers GGJ, van Zon A, Stegeman I, Grolman W. The effect of cochlear implantation on tinnitus in patients with bilateral hearing loss: A systematic review. Laryngoscope 2015; 125:2584-92. [DOI: 10.1002/lary.25370] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/31/2015] [Accepted: 04/14/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Geerte G. J. Ramakers
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht the Netherlands
| | - Alice van Zon
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht the Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht the Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht the Netherlands
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