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Fan S, Zhang C, Chen M, Mao J, Li S. The impact of cochlear implantation on quality of life and psychological status in single-sided deafness or asymmetric hearing loss with tinnitus and influencing factors of implantation intention: a preliminary study. Eur Arch Otorhinolaryngol 2024; 281:95-105. [PMID: 37378727 DOI: 10.1007/s00405-023-08086-7] [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: 03/25/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE The current study aims to explore the therapeutic effect of cochlear implants (CIs) on tinnitus in patients with single-sided deafness or asymmetric hearing loss (SSD/AHL) as well as the improvement of tinnitus-related quality of life and psychological status. In addition, we also explored whether the levels of quality of life and psychological status was related to the patient's implantation intention. METHODS Seven patients decided to receive cochlear implantation. Before and after implantation, they completed the Visual Analogue Scale (VAS) and the Tinnitus Questionnaire (TQ) to assess tinnitus severity, the Speech, Spatial and Qualities of Hearing Scale (SSQ), and the Medical Outcomes Study Short Form 36 Health Survey Questionnaire (SF-36) to assess the quality of life, the Simplified Coping Style Questionnaire (SCSQ) to assess psychological status. The other 8 SSD patients refused cochlear implantation. Their scores of the above questionnaires were compared with those of patients received implantation. RESULTS Six months after cochlear implantations, the tinnitus perception, loudness, and annoyance significantly decreased compared to that before implantation. In terms of quality of life and physiological status, no statistically significant changes were detected in SSQ, SF-36, and SCSQ measurements. The score of annoyance subcategory of VAS and all subcategories of SSQ of patients refused implantation were better than those of implanted patients before implantation. CONCLUSIONS These results suggest that CIs can significantly reduce tinnitus severity. Patients refused implantation had better status in the annoyance of VAS and all subcategories of SSQ scores than those received implantation.
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Affiliation(s)
- Shuwen Fan
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Chen Zhang
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Min Chen
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Jiabao Mao
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Shufeng Li
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China.
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Daher GS, Kocharyan A, Dillon MT, Carlson ML. Cochlear Implantation Outcomes in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis. Otol Neurotol 2023; 44:297-309. [PMID: 36791341 DOI: 10.1097/mao.0000000000003833] [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: 02/17/2023]
Abstract
OBJECTIVE To assess spatial hearing, tinnitus, and quality-of-life outcomes in adults with single-sided deafness (SSD) who underwent cochlear implantation. DATABASES REVIEWED PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from January 2008 to September 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Studies reporting spatial hearing, tinnitus, and quality-of-life outcomes in adult cochlear implant (CI) recipients (≥18 yr old) with SSD were evaluated. Study characteristics, demographic data, spatial hearing (speech recognition in noise, sound source localization), tinnitus (severity, loudness), and quality-of-life outcomes were collected. RESULTS From an initial search of 1,147 articles, 36 studies that evaluated CI use in 796 unique adults with SSD (51.3 ± 12.4 yr of age at time of implantation) were included. The mean duration of deafness was 6.2 ± 9.6 years. There was evidence of improvement for speech recognition in noise using different target-to-masker spatial configurations, with the largest benefit observed for target-to-masker configurations assessing head shadow (mean, 1.87-6.2 dB signal-to-noise ratio). Sound source localization, quantified as root-mean-squared error, improved with CI use (mean difference [MD], -25.3 degrees; 95% confidence interval [95% CI], -35.9 to -14.6 degrees; p < 0.001). Also, CI users reported a significant reduction in tinnitus severity as measured with the Tinnitus Handicap Inventory (MD, -29.97; 95% CI, -43.9 to -16.1; p < 0.001) and an improvement in spatial hearing abilities as measured with the Spatial, Speech, and Qualities of Hearing questionnaire (MD, 2.3; 95% CI, 1.7 to 2.8; p < 0.001). CONCLUSIONS Cochlear implantation and CI use consistently offer improvements in speech recognition in noise, sound source localization, tinnitus, and perceived quality of life in adults with SSD.
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Affiliation(s)
- Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Armine Kocharyan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Margaret T Dillon
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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Oh SJ, Mavrommatis MA, Fan CJ, DiRisio AC, Villavisanis DF, Berson ER, Schwam ZG, Wanna GB, Cosetti MK. Cochlear Implantation in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 168:131-142. [PMID: 35230924 DOI: 10.1177/01945998221083283] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the clinical outcomes of adult patients with single-sided deafness (SSD) undergoing ipsilateral cochlear implantation. DATA SOURCE An electronic search of Medline and Embase articles. REVIEW METHODS A systematic review was performed with a search strategy developed by a licensed librarian to identify studies of adult patients with SSD who underwent ipsilateral cochlear implantation. Articles were managed in Covidence and evaluated by 2 independent reviewers. Risk of bias was assessed and data were extracted, including patient demographics, etiology of deafness, duration of deafness, and postoperative change in speech recognition, tinnitus, sound localization, and quality of life (QoL). A meta-analysis was performed, and pooled mean differences were calculated for each outcome of interest via random effects models by each outcome, as well as subgroup analyses by the individual clinical score used. RESULTS Of 2309 studies identified, 185 full texts were evaluated, and 50 were ultimately included involving 674 patients. Speech perception scores in quiet and noise, tinnitus control, sound localization, and QoL all significantly improved after implantation. Pooled outcomes demonstrated score improvements in speech perception (standardized mean difference [SMD], 2.8 [95% CI, 2.16-3.43]), QoL (SMD, 0.68 [95% CI, 0.45-0.91]), sound localization (SMD, -1.13 [95% CI, -1.68 to -0.57]), and tinnitus score reduction (SMD, -1.32 [95% CI, -1.85 to -0.80]). CONCLUSIONS Cochlear implantation in adults with SSD results in significant improvements in speech perception, tinnitus control, sound localization, and QoL. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Samuel J Oh
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Maria A Mavrommatis
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Caleb J Fan
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Aislyn C DiRisio
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Dillan F Villavisanis
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Elisa R Berson
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Zachary G Schwam
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Maura K Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
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A Protocol to Investigate Deep Brain Stimulation for Refractory Tinnitus: From Rat Model to the Set-Up of a Human Pilot Study. Audiol Res 2022; 13:49-63. [PMID: 36648926 PMCID: PMC9844413 DOI: 10.3390/audiolres13010005] [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: 10/27/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Chronic tinnitus can have an immense impact on quality of life. Despite recent treatment advances, many tinnitus patients remain refractory to them. Preclinical and clinical evidence suggests that deep brain stimulation (DBS) is a promising treatment to suppress tinnitus. In rats, it has been shown in multiple regions of the auditory pathway that DBS can have an alleviating effect on tinnitus. The thalamic medial geniculate body (MGB) takes a key position in the tinnitus network, shows pathophysiological hallmarks of tinnitus, and is readily accessible using stereotaxy. Here, a protocol is described to evaluate the safety and test the therapeutic effects of DBS in the MGB in severe tinnitus sufferers. METHODS Bilateral DBS of the MGB will be applied in a future study in six patients with severe and refractory tinnitus. A double-blinded, randomized 2 × 2 crossover design (stimulation ON and OFF) will be applied, followed by a period of six months of open-label follow-up. The primary focus is to assess safety and feasibility (acceptability). Secondary outcomes assess a potential treatment effect and include tinnitus severity measured by the Tinnitus Functional Index (TFI), tinnitus loudness and distress, hearing, cognitive and psychological functions, quality of life, and neurophysiological characteristics. DISCUSSION This protocol carefully balances risks and benefits and takes ethical considerations into account. This study will explore the safety and feasibility of DBS in severe refractory tinnitus, through extensive assessment of clinical and neurophysiological outcome measures. Additionally, important insights into the underlying mechanism of tinnitus and hearing function might be revealed. TRIAL REGISTRATION ClinicalTrials.gov NCT03976908 (6 June 2019).
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness. Ear Hear 2022; 43:1605-1619. [PMID: 35994570 PMCID: PMC9592177 DOI: 10.1097/aud.0000000000001260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The indications for cochlear implantation have expanded to include individuals with profound sensorineural hearing loss in the impaired ear and normal hearing (NH) in the contralateral ear, known as single-sided deafness (SSD). There are additional considerations for the clinical assessment and management of adult cochlear implant candidates and recipients with SSD as compared to conventional cochlear implant candidates with bilateral moderate to profound sensorineural hearing loss. The present report reviews the current evidence relevant to the assessment and management of adults with SSD. A systematic review was also conducted on published studies that investigated outcomes of cochlear implant use on measures of speech recognition in quiet and noise, sound source localization, tinnitus perception, and quality of life for this patient population. Expert consensus and systematic review of the current literature were combined to provide guidance for the clinical assessment and management of adults with SSD.
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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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Poels L, Zarowski A, Leblans M, Vanspauwen R, van Dinther J, Offeciers E. Prognostic Value of Trial Round Window Stimulation for Selection of Candidates for Cochlear Implantation as Treatment for Tinnitus. J Clin Med 2021; 10:jcm10173793. [PMID: 34501241 PMCID: PMC8432167 DOI: 10.3390/jcm10173793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/08/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
Electrical stimulation with cochlear implants is able to significantly suppress the tinnitus sensations in 25–72% of implanted patients. Up to this point, no clear predictors for the effectiveness of tinnitus suppression with cochlear implants have been found and this substantially limits the possibility of the application of cochlear implants for this purpose. The objective of the study was to investigate if a trial electrical round window stimulation (RWS) could be used as a diagnostic tool for identifying candidates in whom electrical stimulation would be successful as treatment for tinnitus. Thirty-four patients with unilateral severe tinnitus and ipsilateral moderate to severe sensorineural hearing loss underwent a trial RWS under local anesthesia. Thirteen patients received a cochlear implant. All patients qualified for cochlear implantation on the basis of the trial RWS showed tinnitus suppression with the implant switched on. Complete or almost complete tinnitus suppression was obtained in 77% and partial in 23%. The mean tinnitus loudness reduction was 68% (VAS score reduction from 7.7 to 2.5). False negative results are estimated not to exceed 10–15%. We conclude that significant tinnitus suppression achieved during trial RWS under local anesthesia is a simple procedure allowing the efficient identification of candidates in whom electrical stimulation with a cochlear implant would be successful as treatment for intractable tinnitus.
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Dhanwani R, Prajapati A, Dimri A, Varmora A, Shah M. Smart Earth Technologies: a pressing need for abating pollution for a better tomorrow. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:35406-35428. [PMID: 34018104 DOI: 10.1007/s11356-021-14481-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
Standing at the cusp of an augmented age facilitates a glance into the future of a cybernetic world aligned with planetary wellbeing. The era of exponential technological revolutions has brought with it a plethora of opportunities expanding in a multi-faceted dimension with an added emphasis towards nurturing a mutual synergy of nature with a daily dose of digitalization. The paper is written with an intent to lay out an accumulated comprehensive review of different literary works which lay the grounds for how different Smart Earth Technologies aid in monitoring and tackling the degradation of air and water resources. If an intertwined state-of-the-art centralized research source could be created, it would become a boon for seasoned researchers and neophytes succeeding portion of the article expands itself to a wide variety of research literature complimented with real-time models, case, and empirical studies which help heighten the previous limit to the research done on these Technologies tinkering the present monitoring systems. The primary aim of this work is to fuel the need of theoretical, practical, and empirical evolution in the ways the intelligent technologies help blossom a pollution-free environment. The secondary intention was to ensure that in-depth study of Smart Environmental Pollution the Monitoring Systems provisioned a multitude of prospects for upgrading one's knowledge on environmental management through current world technologies. By looking at these trends of the past, the enthusiast of technology could collaborate with the researchers of Environmental Pollution to assist in proliferation of diverse 'smart' solutions creating a Smarter, Greener, and Brighter future for research and developments in Sustainable Technologies devising a pollution-free environment.
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Affiliation(s)
- Riya Dhanwani
- Department of Information and Communication Technology, School of Technology, Pandit Deendayal Energy University, Gandhinagar, Gujarat, India
| | - Annshu Prajapati
- Department of Information and Communication Technology, School of Technology, Pandit Deendayal Energy University, Gandhinagar, Gujarat, India
| | - Ankita Dimri
- Department of Information and Communication Technology, School of Technology, Pandit Deendayal Energy University, Gandhinagar, Gujarat, India
| | - Aayushi Varmora
- Department of Information and Communication Technology, School of Technology, Pandit Deendayal Energy University, Gandhinagar, Gujarat, India
| | - Manan Shah
- Department of Chemical Engineering, School of Technology, Pandit Deendayal Energy University, Gandhinagar, Gujarat, India.
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Associations Between Hearing Health and Well-Being in Unilateral Hearing Impairment. ACTA ACUST UNITED AC 2021; 42:520-530. [DOI: 10.1097/aud.0000000000000969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang J, Firestone E, Elattma A. Animal Models of Tinnitus Treatment: Cochlear and Brain Stimulation. Curr Top Behav Neurosci 2021; 51:83-129. [PMID: 34282563 DOI: 10.1007/7854_2021_227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuromodulation, via stimulation of a variety of peripheral and central structures, is used to suppress tinnitus. However, investigative limitations in humans due to ethical reasons have made it difficult to decipher the mechanisms underlying treatment-induced tinnitus relief, so a number of animal models have arisen to address these unknowns. This chapter reviews animal models of cochlear and brain stimulation and assesses their modulatory effects on behavioral evidence of tinnitus and its related neural correlates. When a structure is stimulated, localized modulation, often presenting as downregulation of spontaneous neuronal spike firing rate, bursting and neurosynchrony, occurs within the brain area. Through anatomical projections and transmitter pathways, the interventions activate both auditory- and non-auditory structures by taking bottom-up ascending and top-down descending modes to influence their target brain structures. Furthermore, it is the brain oscillations that cochlear or brain stimulation evoke and connect the prefrontal cortex, striatal systems, and other limbic structures to refresh neural networks and relieve auditory, attentive, conscious, as well as emotional reactive aspects of tinnitus. This oscillatory neural network connectivity is achieved via the thalamocorticothalamic circuitry including the lemniscal and non-lemniscal auditory brain structures. Beyond existing technologies, the review also reveals opportunities for developing advanced animal models using new modalities to achieve precision neuromodulation and tinnitus abatement, such as optogenetic cochlear and/or brain stimulation.
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Affiliation(s)
- Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA. .,Department of Communication Sciences and Disorders, Wayne State University College of Liberal Arts and Sciences, Detroit, MI, USA.
| | - Ethan Firestone
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ahmed Elattma
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
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Cochlear implant and tinnitus-a meta-analysis. Braz J Otorhinolaryngol 2020; 87:353-365. [PMID: 33342697 PMCID: PMC9422519 DOI: 10.1016/j.bjorl.2020.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 01/16/2023] Open
Abstract
Introduction Tinnitus is a frequent symptom in cochlear implant patients, often reported as persistent and disabling in implant candidates. Tinnitus is rarely considered in the preoperative evaluation of patients who are eligible for cochlear implantation. Many studies have shown that a cochlear implant leads to a significant change in the perception of tinnitus. Objective To identify evidence in the scientific literature indicating that cochlear implant in eligible patients with tinnitus can improve tinnitus perception. Methods One hundred forty articles were found from nine databases, and 20 articles from the gray literature mentioned the relationship between cochlear implant and tinnitus perception in patients eligible for cochlear implant. The PICOS (population, intervention, comparison, and outcome) strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies and the Joanna Briggs Institute critical appraisal checklist for randomized clinical trials. Results The full texts of 11 articles were read, and 6 studies were selected for the meta-analysis. The total sample size in the evaluated articles was 136 patients with tinnitus who were eligible for cochlear implantation. Conclusions Taken together, these findings support the feasibility of cochlear implantation to reduce the perception of tinnitus, thus providing a new perspective in the treatment of tinnitus in patients with hearing loss who are candidates for cochlear implantation.
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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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Olze H, Vater J, Szczepek AJ, Reich U, Gräbel S, Uecker FC. Advances in electrical stimulation-based therapy for tinnitus. CURRENT DIRECTIONS IN BIOMEDICAL ENGINEERING 2020. [DOI: 10.1515/cdbme-2020-2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Tinnitus is a phantom percept of noise heard only by the affected person. The principal problem of persons suffering from tinnitus is the inability to deflect their attention from the phantom sound, resulting in insomnia and problems with concentration, followed by significant health issues. To date, no therapy would relieve patients from the phantom sound. Instead, commonly used therapeutic approaches for tinnitus aim primarily at the reduction of tinnitus-induced distress and are based on various tinnitus habituation methods. Our project aims to quench the tinnitus percept using an implant. To develop such an implant, this research group joined the INTAKT network initiated by the German Federal Ministry of Education and Research and dedicated to the development of smart implants. During this still ongoing, prospective clinical study, the efficacy of two protocols using electrical stimulation is assessed for tinnitus silencing. The electrical stimulation used in the presented study is non-invasive and applied on three consecutive days in the form of short sessions. In a sample of 48 subjects, following three stimulation sessions, 48% of patients reported a significant reduction of tinnitus loudness; 10% reported a brief increase of tinnitus loudness, and 42% stated no change. In one case, the first course of stimulation led to the total distinguishing of tinnitus. On average, the stimulation did not affect the grade of tinnitus-induced distress during the time of measurement. Our current results prompt us to broaden our investigations, expand the subject sample, and further optimize the stimulation conditions.
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Affiliation(s)
- Heidi Olze
- Department of Otorhinolaryngology, Head and Neck Surgery , CCM/CVK, Charité Universitaetsmedizin Berlin , Berlin , Germany
| | - Jana Vater
- Department of Otorhinolaryngology, Head and Neck Surgery , CCM/CVK, Charité Universitaetsmedizin Berlin , Berlin , Germany
| | - Agnieszka J. Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery , CCM/CVK, Charité Universitaetsmedizin Berlin , Berlin , Germany
| | - Uta Reich
- Department of Otorhinolaryngology, Head and Neck Surgery , CCM/CVK, Charité Universitaetsmedizin Berlin , Berlin , Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Head and Neck Surgery , CCM/CVK, Charité Universitaetsmedizin Berlin , Berlin , Germany
| | - Florian Cornelius Uecker
- Department of Otorhinolaryngology, Head and Neck Surgery , CCM/CVK, Charité Universitaetsmedizin Berlin , Berlin , Germany
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Assouly KKS, van Heteren JAA, Stokroos RJ, Stegeman I, Smit AL. Cochlear implantation for patients with tinnitus - A systematic review. PROGRESS IN BRAIN RESEARCH 2020; 260:27-50. [PMID: 33637223 DOI: 10.1016/bs.pbr.2020.06.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cochlear implantation (CI) is used in patients with severe-to-profound hearing loss when hearing aids provide limited or no benefit for speech perception. Studies on this topic reported tinnitus reduction as a common side effect of the electrical activation after cochlear implantation. So far, it is unclear what the effect is when patients do receive their implant primarily because of tinnitus complaints. OBJECTIVES To assess the effectiveness of the electrical stimulation with a cochlear implant in patients with tinnitus as a primary complaint, by systematically reviewing the literature. METHODS Two independent authors identified studies, extracted data and assessed risk of bias of included studies. Original studies reporting outcomes of electrical stimulation by cochlear implantation for primarily tinnitus (defined as severe or incapacitating distress levels) were included, if they reported a follow-up of at least three months. The pre- and post-implantation tinnitus distress scores on single and/or multi-item questionnaires of the included studies were extracted. RESULTS In total, 4091 unique articles were retrieved. After screening titles, abstracts and full texts, we included seven prospective cohort studies (105 subjects in total, range: 10-26). All studies had considerable risks of bias. All tinnitus patients in the included studies had asymmetrical hearing loss or single-sided deafness. A statistically significant tinnitus distress improvement based on tinnitus questionnaire scores was found in every study. CONCLUSION Our systematic review reveals that electrical stimulation by cochlear implants in patients with a primary complaint of tinnitus has a positive impact on tinnitus distress. Nevertheless, only small sample sizes were found and studies showed considerable risks of bias.a.
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Affiliation(s)
- Kelly K S Assouly
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical and Experimental Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands; Cochlear Technology Center, Mechelen, Belgium.
| | - Jan A A van Heteren
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical and Experimental Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical and Experimental Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical and Experimental Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical and Experimental Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
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15
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Kloostra FJJ, de Kleine E, Free RH, Hofman R, Van Dijk P. Changes in Tinnitus by Cochlear Implantation: A Parametric Study of the Effect of Single-Electrode Stimulation. Audiol Neurootol 2020; 26:140-148. [PMID: 32894830 DOI: 10.1159/000509202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 05/29/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION While cochlear implantation may have a positive effect on tinnitus, it is not effective in reducing tinnitus in all patients. This may be due to different patients requiring different strategies of electrical stimulation in order to obtain a positive effect on tinnitus. It is, therefore, important to identify the most effective stimulation strategies to reduce tinnitus. The simplest possible strategy is stimulation by only one electrode. In this study, we investigated tinnitus suppression by electrical stimulation via a single electrode of the cochlear implant. METHODS We performed a listening experiment in 19 adult participants, who had received a unilateral cochlear implant (CI) because of severe bilateral hearing loss. All of these patients had indicated that they suffered from tinnitus. During a 300-s interval, patients listened to blocks of single-electrode stimulation and rated the loudness of the stimulus and any effects on their tinnitus. The 300-s interval included a block of single-electrode stimulation (duration 120 s). In consecutive intervals, the stimulus differed in its cochlear location (basal or apical), its pulse rate (720 or 725 Hz, 1,200 Hz, and 2,400 or 2,320 Hz), and amplitude (just above threshold or equivalent to moderate loudness). Thus, 2 × 3 × 2 = 12 stimulus conditions were tested in each participant, and each condition was presented only once. During the experiment, the participants promptly rated the loudness of the stimuli and the loudness of their tinnitus on a Visual Analogue Scale (10-point VAS). RESULTS Significantly more tinnitus reduction was observed with stimuli at a moderate intensity level (30%) compared to stimuli at near-threshold level (18%) (χ2 [1, N = 222] = 14.115, p < 0.01). No significant differences in tinnitus levels resulted from the different pulse rates and stimulation sites. Eight participants reported an increase of tinnitus loudness under at least one stimulus condition. Changes in tinnitus loudness were generally minor, and never exceeded 3 points on the VAS. The overall effect of cochlear implantation on tinnitus, that is, the effect with full-array stimulation, was not correlated with the effectiveness of the single-electrode stimulation on tinnitus. CONCLUSION In conclusion, the effect of single-electrode stimulation on tinnitus is relatively insignificant in comparison to the effect of full-array stimulation. However, in some individual cases, sustained single-electrode stimulation may be beneficial for tinnitus management.
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Affiliation(s)
- Francka J J Kloostra
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands, .,Graduate School of Medical Sciences, Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands,
| | - Emile de Kleine
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands.,Graduate School of Medical Sciences, Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Rolien H Free
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands.,Graduate School of Medical Sciences, Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Rutger Hofman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands.,Graduate School of Medical Sciences, Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Pim Van Dijk
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands.,Graduate School of Medical Sciences, Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
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Welling DB, Jackler RK. Reflections on the Last 25 Years of the American Otological Society and Thoughts on its Future. Otol Neurotol 2019. [PMID: 29533378 DOI: 10.1097/mao.0000000000001760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To review contributions of the American Otological Society (AOS) over the most recent quarter century (1993-2018) and to comment on possible future evolution of the field during the quarter century to come. METHODS Retrospective review of selected topics from the AOS transactions, distinguished lectureships over the past 25 years, and selective reflection by the authors. Speculation on potential advances of the next quarter century derived from emerging topics in the current literature and foreseeable trends in science and technology are also proffered for consideration (and possible future ridicule). RESULTS Integration of multiple disciplines including bioengineering, medical imaging, genetics, molecular biology, physics, and evidence based medicine have substantially benefitted the practice of otology over the past quarter century. The impact of the contributions of members of the AOS in these developments cannot be over estimated. CONCLUSIONS Further scientific advancement will certainly accelerate change in the practice of otologic surgery and medicine over the coming decade in ways that will be marvelous to behold.
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Affiliation(s)
- D Bradley Welling
- Harvard Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Robert K Jackler
- Department of Otolaryngology Head and Neck Surgery, Stanford University, Stanford, California
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17
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van Zwieten G, Janssen MLF, Smit JV, Janssen AML, Roet M, Jahanshahi A, Stokroos RJ, Temel Y. Inhibition of Experimental Tinnitus With High Frequency Stimulation of the Rat Medial Geniculate Body. Neuromodulation 2018; 22:416-424. [PMID: 30102446 PMCID: PMC6618158 DOI: 10.1111/ner.12795] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/28/2018] [Accepted: 05/02/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Neuromodulation is a promising treatment modality for tinnitus, especially in chronic and severe cases. The auditory thalamus plays a key role in the pathophysiology of tinnitus, as it integrates and processes auditory and limbic information. OBJECTIVE The effect of high frequency stimulation and low frequency stimulation of the medial geniculate bodies on tinnitus in a noise-induced tinnitus rat model is assessed. MATERIALS AND METHODS Presence of tinnitus was verified using the gap-induced prepulse inhibition of the acoustic startle response paradigm. Hearing thresholds were determined before and after noise trauma with auditory brainstem responses. Anxiety-related side-effects were evaluated in the elevated zero maze and open field. RESULTS Results show tinnitus development after noise exposure and preserved hearing thresholds of the ear that was protected from noise trauma. We found that high frequency stimulation of the medial geniculate bodies suppressed tinnitus. This effect maintained directly after stimulation when the stimulator was turned off. Low frequency stimulation did not have any effects on the gap:no-gap ratio of the acoustic startle response. CONCLUSION High frequency stimulation of the MGB has a direct and residual suppressing effect on tinnitus in this animal model. Low frequency stimulation of the MGB did not inhibit tinnitus.
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Affiliation(s)
- Gusta van Zwieten
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marcus L F Janssen
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurology and Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jasper V Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - A Miranda L Janssen
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Milaine Roet
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ali Jahanshahi
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J Stokroos
- Department of Ear Nose and Throat/Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yasin Temel
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
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18
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Smit JV, Pielkenrood BJ, Arts RAGJ, Janssen ML, Temel Y, Stokroos RJ. Patient Acceptance of Invasive Treatments for Tinnitus. Am J Audiol 2018; 27:184-196. [PMID: 29507954 DOI: 10.1044/2017_aja-17-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 09/28/2017] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The field of neuromodulation is currently seeking to treat a wide range of disorders with various types of invasive devices. In recent years, several preclinical trials and case reports in humans have been published on their potential for chronic tinnitus. However, studies to obtain insight into patients' willingness to undergo these treatments are scarce. The aim of this survey study was to find out whether tinnitus patients are willing to undergo invasive neuromodulation when taking its risks, costs, and potential benefits into account. METHOD A Visual Analog Scale (VAS, 0-10) was used to measure the outcome. Spearman's rank-order correlation coefficients were computed to determine the correlation between patient characteristics and acceptance rates. RESULTS Around one fifth of the patients were reasonably willing to undergo invasive treatment (VAS 5-7), and around one fifth were fully willing to do so (VAS 8-10). Hearing aids, used as a control, were accepted most, followed by cochlear implantation, deep brain stimulation, and cortical stimulation. Acceptance rates were slightly higher when the chance of cure was higher. Patients with a history of attempted treatments were more eager than others to find a new treatment for tinnitus. CONCLUSIONS A considerable proportion of patients with tinnitus would accept a variety of invasive treatments despite the associated risks or costs. When clinical neuromodulatory studies for tinnitus are to be performed, particular attention should be given to obtaining informed consent, including explaining the potential risks and providing a realistic outcome expectation.
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Affiliation(s)
- Jasper V. Smit
- Department of Ear, Nose, and Throat/Head and Neck Surgery, Maastricht University Medical Center, The Netherlands
| | - Bart J. Pielkenrood
- Department of Ear, Nose, and Throat/Head and Neck Surgery, Maastricht University Medical Center, The Netherlands
| | - Remo A. G. J. Arts
- Department of Ear, Nose, and Throat/Head and Neck Surgery, Maastricht University Medical Center, The Netherlands
| | - Miranda L. Janssen
- Department of Methodology and Statistics, Maastricht University Medical Center, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, The Netherlands
| | - Robert J. Stokroos
- Department of Ear, Nose, and Throat/Head and Neck Surgery, Maastricht University Medical Center, The Netherlands
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Mertens G, Van Rompaey V, Van de Heyning P. Electric-acoustic stimulation suppresses tinnitus in a subject with high-frequency single-sided deafness. Cochlear Implants Int 2018; 19:292-296. [DOI: 10.1080/14670100.2018.1473940] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Arts RAGJ, George ELJ, Janssen MAML, Griessner A, Zierhofer C, Stokroos RJ. The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training. Int J Audiol 2017; 57:426-439. [DOI: 10.1080/14992027.2017.1408964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Remo A. G. J. Arts
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
| | - Erwin L. J. George
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
| | - Miranda A. M. L. Janssen
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
- Department of Methodology and Statistics, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands, and
| | - Andreas Griessner
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Clemens Zierhofer
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Robert J. Stokroos
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
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Ralli M, Greco A, Turchetta R, Altissimi G, de Vincentiis M, Cianfrone G. Somatosensory tinnitus: Current evidence and future perspectives. J Int Med Res 2017; 45:933-947. [PMID: 28553764 PMCID: PMC5536427 DOI: 10.1177/0300060517707673] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/10/2017] [Indexed: 11/15/2022] Open
Abstract
In some individuals, tinnitus can be modulated by specific maneuvers of the temporomandibular joint, head and neck, eyes, and limbs. Neuroplasticity seems to play a central role in this capacity for modulation, suggesting that abnormal interactions between the sensory modalities, sensorimotor systems, and neurocognitive and neuroemotional networks may contribute to the development of somatosensory tinnitus. Current evidence supports a link between somatic disorders and higher modulation of tinnitus, especially in patients with a normal hearing threshold. Patients with tinnitus who have somatic disorders seems to have a higher chance of modulating their tinnitus with somatic maneuvers; consistent improvements in tinnitus symptoms have been observed in patients with temporomandibular joint disease following targeted therapy for temporomandibular disorders. Somatosensory tinnitus is often overlooked by otolaryngologists and not fully investigated during the diagnostic process. Somatic disorders, when identified and treated, can be a valid therapeutic target for tinnitus; however, somatic screening of subjects for somatosensory tinnitus is imperative for correct selection of patients who would benefit from a multidisciplinary somatic approach.
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Affiliation(s)
- Massimo Ralli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
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Arts RAGJ, George ELJ, Janssen M, Griessner A, Zierhofer C, Stokroos RJ. Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness - A Prospective Clinical Trial: Follow-Up. PLoS One 2016; 11:e0153131. [PMID: 27111333 PMCID: PMC4844154 DOI: 10.1371/journal.pone.0153131] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 03/24/2016] [Indexed: 02/06/2023] Open
Abstract
Introduction Earlier studies show that a Cochlear Implant (CI), capable of providing intracochlear electrical stimulation independent of environmental sounds, appears to suppress tinnitus at least for minutes. The current main objective is to compare the long-term suppressive effects of looped (i.e. repeated) electrical stimulation (without environmental sound perception) with the standard stimulation pattern of a CI (with environmental sound perception). This could open new possibilities for the development of a “Tinnitus Implant” (TI), an intracochlear pulse generator for the suppression of tinnitus. Materials and Methods Ten patients with single sided deafness suffering from unilateral tinnitus in the deaf ear are fitted with a CI (MED-EL Corporation, Innsbruck, Austria). Stimulation patterns are optimized for each individual patient, after which they are compared using a randomized crossover design, with a follow-up of six months, followed by a 3 month period using the modality of patient’s choice. Results Results show that tinnitus can be suppressed with intracochlear electrical stimulation independent of environmental sounds, even long term. No significant difference in tinnitus suppression was found between the standard clinical CI and the TI. Conclusion It can be concluded that coding of environmental sounds is no requirement for tinnitus suppression with intracochlear electrical stimulation. It is therefore plausible that tinnitus suppression by CI is not solely caused by an attention shift from the tinnitus to environmental sounds. Both the standard clinical CI and the experimental TI are potential treatment options for tinnitus. These findings offer perspectives for a successful clinical application of the TI, possibly even in patients with significant residual hearing. Trial Registration TrialRegister.nl NTR3374
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Affiliation(s)
- Remo A. G. J. Arts
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, the Netherlands
- * E-mail:
| | - Erwin L. J. George
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, the Netherlands
| | - Miranda Janssen
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, the Netherlands
- Department of Methodology and Statistics, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, the Netherlands
| | - Andreas Griessner
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Clemens Zierhofer
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Robert J. Stokroos
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, the Netherlands
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van Zwieten G, Smit JV, Jahanshahi A, Temel Y, Stokroos RJ. Tinnitus: Is there a place for brain stimulation? Surg Neurol Int 2016; 7:S125-9. [PMID: 26958429 PMCID: PMC4765244 DOI: 10.4103/2152-7806.176134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/05/2016] [Indexed: 12/16/2022] Open
Abstract
Tinnitus is the perception of a “phantom sound” and has a high prevalence. Although many therapies have been investigated within the last decades, there is still no effective standard therapy. Animal studies and human functional imaging studies revealed that tinnitus perception is associated with many complex changes in multiple brain structures. There is growing evidence that brain stimulation might be able to interrupt the local altered neuronal activity and hereby inhibit tinnitus perception. In this editorial review, an update is given on the most promising targets for brain stimulation. Promising structures for stimulation are the dorsal cochlear nucleus, the inferior colliculus and the medial geniculate body of the thalamus. For cortical stimulation, the auditory cortex is considered as a target. Nevertheless, the field is waiting for evidence from well-designed clinical trials, based on supporting evidence from experimental/mechanistic research, to support or discourage the application of brain stimulation in tinnitus.
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Affiliation(s)
- Gusta van Zwieten
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Jasper V Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Ali Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Robert J Stokroos
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
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Devocht EM, Dees G, Arts RA, Smits JJ, George EL, van Hoof M, Stokroos RJ. Revisiting Place-Pitch Match in CI Recipients Using 3D Imaging Analysis. Ann Otol Rhinol Laryngol 2015; 125:378-84. [DOI: 10.1177/0003489415616130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To improve the estimation of the perceived pitch in a single-sided deaf cochlear implant (CI) listener by using accurate 3-dimensional (3D) image analysis of the cochlear electrode positions together with the predicted tonotopical function for humans. Methods: An SSD CI user underwent a Cone-Beam computed tomography (CBCT) scan. Electrode contacts were marked in 3D space in relation to the nearest point on the cochlear lateral wall. Distance to the base of the lateral wall was calculated and plotted against the place-pitch function for humans. An adaptive procedure was used to elicit the perceived pitch of electrically evoked stimulation by matching it with a contralateral acoustic pitch. Results: The electrically evoked pitch percept matched well with the calculated frequency. The median mismatch in octaves was 0.12 for our method in comparison to 0.69 using the conventional Stenvers view. Conclusion: A method of improved image analysis is described that can be used to predict the pitch percept on corresponding cochlear electrode positions. This method shows the potential of 3D imaging in CI fitting optimization.
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Affiliation(s)
- Elke M.J. Devocht
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Guido Dees
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Remo A.G.J. Arts
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jeroen J. Smits
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Erwin L.J. George
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marc van Hoof
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J. Stokroos
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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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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