11 research outputs found
Tinnitus & Cochlear Implants
A cochlear implant is an electronic device that can help to restore hearing in patients who have severe bilateral sensorineural hearing loss. This thesis aims to obtain more insight into the number of patients that might benefit from cochlear implantation concerning tinnitus. We did two questionnaire studies, which showed that the prevalence of tinnitus in cochlear implant patients is 51-66%. The tinnitus severity is generally mild to moderate. Cochlear implantation reduces tinnitus in an important part of the patients (56-75%), but in a small part of the patients (0-28%) cochlear implantation has a negative influence on tinnitus. However, in the patients who show tinnitus deterioration the tinnitus handicap does not increase and in the patients who show tinnitus onset after implantation the tinnitus handicap is mild. Based on the questionnaire studies we created a prognostic model that showed that the lower the preoperative tinnitus handicap and the preoperative hearing handicap, the higher the chance that cochlear implantation will worsen tinnitus. This result suggests that preoperative screening with tinnitus- and hearing handicap questionnaires could be meaningful. Further, we performed a study in which we explored single electrode stimulation to reduce tinnitus perception. We found that the effect of single-electrode stimulation on tinnitus is relatively small in comparison to the effect of full-array stimulation, but in some cases sustained single electrode stimulation may be beneficial for tinnitus management
Models to predict positive and negative effects of cochlear implantation on tinnitus
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
Changes in Tinnitus by Cochlear Implantation:A Parametric Study of the Effect of Single-Electrode Stimulation
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%) ([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
A Prospective Study of the Effect of Cochlear Implantation on Tinnitus
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. (C) 2019 The Author(s) Published by S. Karger AG, Basel</p
Dataset: Changes in Tinnitus by chochlear implantation
raw data to reproduce figure 2 of the paper: CHANGES IN TINNITUS BY COCHLEAR IMPLANTATION: A PARAMETRIC STUDY OF THE EFFECT OF SINGLE-ELECTRODE STIMULATION. 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)