Cochlear Implant (CI) for SSD + Tinnitus

[alexh]

I have SSD due to sudden hearing loss a year ago because of a Stapedectomy that went wrong.

I developed Tinnitus and I am thinking on having a CI to deal with this problem. I would love to hear someone with experience on this matter.

Did the CI helped you (or not) with the tinnitus? Thanks!

 

[GregCA]

I have SSD due to sudden hearing loss a year ago because of a Stapedectomy that went wrong.

I developed Tinnitus and I am thinking on having a CI to deal with this problem. I would love to hear someone with experience on this matter.

Did the CI helped you (or not) with the tinnitus? Thanks!

I'm sorry about your (hearing) loss - I went through a stapedotomy a couple of years ago and I was lucky to not have had such complication. My T didn't decrease though.

Does your other ear hear well? If so, will doctors still move ahead with implantation on one side? Does your insurance cover that?

I've read mixed results wrt CI for tinnitus...

 

[alexh]

My other is operated too, but the Stapedectomy went ok. I had bilateral otosclerosis. My T after I loss my hearing is quite bad. My quality of life has decreased substantially and I have tried everything humanly possible to decrease it. Doctors seem quite hopeful about the results of CI for T, which seems to be my last option. This is why I am trying to get some first hand experience. I do not know if they insurance will cover the procedure.

 

[GregCA]

My other is operated too, but the Stapedectomy went ok. I had bilateral otosclerosis. My T after I loss my hearing is quite bad. My quality of life has decreased substantially and I have tried everything humanly possible to decrease it. Doctors seem quite hopeful about the results of CI for T, which seems to be my last option. This is why I am trying to get some first hand experience. I do not know if they insurance will cover the procedure.

I think your approach makes sense. I'd probably do the same thing.
Good luck, and keep us posted!

 

[Frédéric]

Predicting Reduced Tinnitus Burden After Cochlear Implantation in Adults

Abstract

Objective:
Explore patient characteristics associated with tinnitus improvement after cochlear implantation.

Study Design:
Retrospective cohort.

Setting:
Tertiary referral.

Patients:
Adults with bilateral severe-to-profound hearing loss and tinnitus.

Interventions:
Unilateral cochlear implantation.

Results:
From 1996 to 2018, 358 patients endorsed pre-implant tinnitus and had ascertainable tinnitus status at 1-year. Clinically significant improvement in Tinnitus Handicap Inventory (THI) (reduction by at least 7-points) was observed in 262 (73.2%) patients, of whom 155 (59.2%) reported complete resolution. Of the 24 characteristics explored, four were identified as independent predictors of improved tinnitus in logistic regression models. In a multivariable model including identified independent predictors, each 10-percentage point increase in baseline hearing in noise test was associated with an 14% reduction in odds of tinnitus resolution or clinically significant improvement (odds ratio [OR] 0.86, 95% confidence limits [CL] 0.77, 0.96) and preoperative use of a hearing aid in the contralateral ear was associated with a 72% reduction (OR 0.28; 95% CL 0.11, 0.73). Each 10-point increase in baseline Hearing Handicap Inventory for Adults (HHI) score was associated with a 28% increase in odds of tinnitus improvement (OR 1.28; 95% CL 1.07, 1.54). Higher baseline burden of tinnitus was associated with higher odds of tinnitus improvement (OR 1.21 per 10-point THI increase, 95% CL 1.04, 1.40).

Conclusions:
Worse residual hearing and higher baseline hearing and tinnitus handicap are associated with higher odds of tinnitus improvement. Expectations of patients seeking reduced tinnitus burden following cochlear implantation should be managed by counselling regarding odds of tinnitus improvement compared to those with similar residual hearing and tinnitus burden.

Source: https://journals.lww.com/otology-ne...ced_Tinnitus_Burden_After_Cochlear.96251.aspx

 

[Frédéric]

Prospective Multicentric Follow-up Study of Cochlear Implantation in Adults With Single-Sided Deafness: Tinnitus and Audiological Outcomes.

Abstract
OBJECTIVE:
This study investigated the audiological and tinnitus outcomes of cochlear implantation (CI) in adults with single-sided deafness (SSD) and tinnitus.

STUDY DESIGN:
Multicentered prospective, non-randomized intervention study.

SETTING:
Six French CI centers.

PATIENTS:
Twenty-six patients with SSD and incapacitating tinnitus (Tinnitus Handicap Inventory [THI] >58) underwent cochlear implantation.

INTERVENTIONS:
First, CIs delivered only masking white noise stimulation for 1 month and then standard CI stimulation.

MAIN OUTCOME MEASURES:
Before and after CI surgery, patients completed the THI, Tinnitus Reaction Questionnaire (TRQ), Subjective Tinnitus Severity Scale (STSS), and two visual analogue scales quantifying tinnitus loudness and annoyance. Speech perception in spatialized noise was tested at 13 months.

RESULTS:
The first month of white noise stimulation triggered a significant improvement in THI scores (72 ± 9 to 55 ± 20, p < 0.05). No change was observed for the other measures. After 1 year of standard CI stimulation, 23 patients (92%) reported a significant improvement in tinnitus. This improvement started 1 to 2 months after CI and exceeded 40% improvement for 14 patients (54%). Average speech-in-noise perception after 1 year significantly improved for the 23 patients who completed these measures.

CONCLUSIONS:
CI is efficacious to reduce the handicap of patient with SSD and incapacitating tinnitus, leading to a decrease in reported tinnitus and partial restoration of binaural hearing abilities.

Source: https://www.ncbi.nlm.nih.gov/pubmed/31868784

 

[Frédéric]

Cochlear implants in single-sided deafness – clinical results of a Swiss multicentre study

AIM OF THE STUDY

The aim of this multicentre, prospective, open, nonrandomised clinical trial was to demonstrate the clinical efficiency and outcomes of cochlear implants (CIs) in adult patients with post-lingual single-sided deafness (SSD).

METHODS

A group of five left and five right SSD participants were investigated with various clinical tests and questionnaires before and 12 months after CI activation. Changes in hearing thresholds, speech understanding in noise, sound localisation, tinnitus (Tinnitus Handicap Inventory; THI), subjective hearing ability (Speech, Spatial and Qualities of Hearing Scale; SSQ), and quality of life (WHOQOL-BREF) were assessed. In addition, the pre- and postoperative results of the SSD patients were compared with an age- and gender-matched normal hearing control group.

RESULTS

Surgery was uncomplicated in all patients. Two years after implantation, 9 of the 10 patients used their CI regularly for an average of more than 11 hours a day. A significant improvement in speech understanding in noise measured in the sound field using the Oldenburg sentence test could be demonstrated in the two situations in which patients with SSD experience the greatest difficulty: speech from the front and noise at the healthy ear, and speech to the implanted ear and noise from the front. The sound localisation test showed significant improvement of the mean localisation error and the root mean square error after CI activation. Furthermore, a significant reduction of the THI was measured, and the SSQ showed a significant improvement in the subscale speech comprehension and in the subscale spatial hearing. Also, quality of life measured with the WHOQOL-BREF showed a general improvement, which was significant in the global subscale. For this questionnaire, there was no significant difference between the normal-hearing control group and the patients after 12 months of CI use.

CONCLUSION

This study confirmed the clinical benefit of cochlear implantation in patients with SSD. The significant improvement of speech understanding in noise, sound localisation, tinnitus perception, subjective hearing ability, and in particular the improved quality of life support the recommendation that patients with recently acquired SSD should be offered a CI. (Clinical trial registration number on clinicaltrial.gov: NCT01749592)

Full article: https://smw.ch/article/doi/smw.2019.20171