Cochlear Implants as a Treatment of Tinnitus

[ErikaS]

No point in them doing an extended audiogram.

1) Hearing aids work up to 8000 Hz at best.
2) Most people over 30-40 have hearing loss on an extended audiogram.
3) Cochlear implants go up to 8000 Hz.

For me, it was informative to do because it gave me my cause of tinnitus. My case is my own and was able to be determined, but I can see how it could get convoluted given your point above with losing those frequencies earlier/first. Many want to know their cause so they know what could possibly help/not help at all and just for closure. I hate that it was this (SSHL), I wish it wasn't, but at least I know.

I wouldn't benefit from these devices that provide frequency amplification, but maybe I could benefit from like the currently trialed Mayo Clinic's tinnitus device that just uses electrical impulses to the cochlea.

 

[momus]

Would losing the ability to hear high frequency noises mitigate one's tinnitus? It might leave it the same or make it worse, or seem to be worse, because you would be losing some of the ability to mask the tinnitus w/ white or pink noises.

I haven't looked at the studies for cochlear implants for 10 or 15 years. At that time, the results seemed to be mixed. I'm 71, have had tinnitus for around two decades, and still have excellent hearing, although it seems I've lost some at the higher frequencies. What's odd is that even when my tinnitus amps up I still have excellent hearing over it.

What I'm getting at is that we all have tinnitus here, but one person's experience may be completely different than someone else's experience. I would look at all the options and read every study that I could find before considering something as drastic (to me) as a cochlear implant. The link below goes to the downsides that might occur w/ a cochlear implant, and they are no joke.

FDA: Benefits and Risks of Cochlear Implants

 

[Nick47]

For me, it was informative to do because it gave me my cause of tinnitus. My case is my own and was able to be determined, but I can see how it could get convoluted given your point above with losing those frequencies earlier/first. Many want to know their cause so they know what could possibly help/not help at all and just for closure. I hate that it was this (SSHL), I wish it wasn't, but at least I know.

I wouldn't benefit from these devices that provide frequency amplification, but maybe I could benefit from like the currently trialed Mayo Clinic's tinnitus device that just uses electrical impulses to the cochlea.

@ErikaS, I think it's natural to want to know. The issue is outside of that 8,000 Hz frequency, we don't (yet) have any treatments so, from an audiology point of view, it's not worth testing. Hearing aids and cochlear implants generally go up to 8,000 Hz. Then unless you have an extended audiogram from years ago, you won't know if you recently lost hearing and that's the cause. Does anyone over age 30 hear 250 Hz - 20,000 Hz? Yet most have lost hearing but have no tinnitus.

 

[Hardwell]

@ErikaS, I think it's natural to want to know. The issue is outside of that 8,000 Hz frequency, we don't (yet) have any treatments so, from an audiology point of view, it's not worth testing. Hearing aids and cochlear implants generally go up to 8,000 Hz. Then unless you have an extended audiogram from years ago, you won't know if you recently lost hearing and that's the cause. Does anyone over age 30 hear 250 Hz - 20,000 Hz? Yet most have lost hearing but have no tinnitus.

I agree it's not worth testing in regards to hearing aids and cochlear implants. But in regards to SSNHL, which I believe is classified as hearing loss over three consecutive frequencies, then an extended audiogram could be given to see if treatment should be administered the same way it would if SSNHL occurred within the normal 8 kHz range.

I understand this would be difficult, like you said, because most people over age 30 have hearing loss in those frequencies anyway, so unless there was a recent audiogram done beforehand, it would be hard to tell if it was sudden hearing loss or gradual.

 

[JRC1]

In my case a team of audiologists and a surgeon determined it by case of severeness and word discrimination, including how it affects your quality of life. I had a hard time hearing with my good ear over the tinnitus etc. It's a tough decision but I had nothing to lose.

When not using my processor, it will escalate over 2 days to awful levels.

My tinnitus is still not totally gone, but after 6 months I can sit in a quiet space and not notice it.

There is no headset that's going to fix tinnitus. It has to be a drug, surgery, or some serious electrical current in my opinion.

My cochlear implant is awful in wind and loud echo-y restaurants and rooms. Keep that in mind.

Did you get the cochlear implant for hearing loss or tinnitus, or both? Did you have hyperacusis? Are you glad you got the implant?

 

[Nick47]

Did you get the cochlear implant for hearing loss or tinnitus, or both? Did you have hyperacusis? Are you glad you got the implant?

@Piney, I don't know if you're still around to answer the above. A person with experience is best!

 

[chadders]

What are the risks of a cochlear implant? It permanently destroys your normal hearing, so you can't remove the implant and go back to your earlier hearing? Can the surgery fail and you are left with awful tinnitus and being deaf?

 

[Nick47]

What are the risks of a cochlear implant? It permanently destroys your normal hearing, so you can't remove the implant and go back to your earlier hearing? Can the surgery fail and you are left with awful tinnitus and being deaf?

@chadders, basically yes, it can destroy residual hearing. It's rare for it to fail i.e. not provide hearing. Worsening or new tinnitus is seen in about 5-10%.

 

[Piney]

Did you get the cochlear implant for hearing loss or tinnitus, or both? Did you have hyperacusis? Are you glad you got the implant?

My tinnitus was doing well with CROS hearing aids, but I couldn't hear over my tinnitus with my good ear. I have no hyperacusis except for a couple times at night.

Yes, I occasionally take the implant off for a day and it's too much; I have to put it back on.

 

[Nick47]

The effect of cochlear implant and bimodal stimulation on tinnitus: a multinational survey

Conclusions and Significance: Taken together, our findings support CI's efficacy in reducing the perception of tinnitus. No significant differences were evident between unilateral and bilateral electrical stimulation in terms of tinnitus improvement.

 

[Nick47]

Early effects of very early cochlear implant activation on tinnitus

Conclusion: On average, most patients with tinnitus will note a significant improvement in their tinnitus handicap when activated within 24 hours of cochlear implantation. 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, though should be counseled that they may experience an exacerbation during the very early post-operative period.

 

[AfroSnowman]

They just need to get the stimulus in there without destroying the rest of the cochlea.

I pray that Susan Shore's device works but some of the descriptions of a near immediate reduction in sound makes me think this is the real winner.

 

[Nick47]

They just need to get the stimulus in there without destroying the rest of the cochlea.

I pray that Susan Shore's device works but some of the descriptions of a near immediate reduction in sound makes me think this is the real winner.

What we need for those with some hearing loss and tinnitus, is a way to preserve more residual hearing during implantation. Many surgeons and researchers are aware of this as well as the implant companies. Richard Tyler also noted this in his literature.

By preserving more residual hearing, you are massively increasing the potential number of candidates.

 

[dd314]

Regardless of what the studies say, there is still a chance of worsening tinnitus, in a similar way that Lenire is a complete gamble.

 

[Watasha]

They just need to get the stimulus in there without destroying the rest of the cochlea.

I pray that Susan Shore's device works but some of the descriptions of a near immediate reduction in sound makes me think this is the real winner.

I believe this is the biggest bang for the buck future treatment out there. It appears likely to be far more effective than Susan Shore's device, but it will also be more invasive.

Fingers crossed they both work very well!

Regardless of what the studies say, there is still a chance of worsening tinnitus, in a similar way that Lenire is a complete gamble.

A complete gamble? Or an improbable gamble?

 

[Nick47]

Regardless of what the studies say, there is still a chance of worsening tinnitus, in a similar way that Lenire is a complete gamble.

The issue with Lenire is there's little chance of improvement. With cochlear implants it's about 70-75%. Plus if they can preserve more residual hearing, a chance of better hearing too.

 

[ErikaS]

I came across a health story/journey recently of this young girl, she is currently 22 or 23. She was very sick starting around the age of 12. Many health conditions from almost dying from meningitis to losing total hearing in one ear from Meniere's disease.

Long story short, Lyme disease was the driving factor of all of these things, so once she ridded the Lyme from her body, she became much better/healthier. However, the hearing in her one ear never returned and she stated she had "really noisy" tinnitus in that ear. So this past year she decided to get a cochlear implant for that ear. She said it took some time to get used to, but the once very noisy and multi-sound tinnitus that existed in that ear is completely gone when she has her cochlear implant in/on. She says she will take it off for sleep and when she awakes in the morning, she can hear the tinnitus very lightly starting to come back, but as soon as she puts the outer part back on, she's back to silence in that ear. She said she has some tinnitus in her other ear, but said it's so much more manageable as it's not nearly as bad as her hearing loss ear was.

With that story and others, I hope research continues in the area of extra-cochlear stimulation like others mentioned above to find a successful middle ground where natural hearing can be preserved. I strongly believe this will be a huge breakthrough treatment success in the future, especially for those with known nerve damage to the inner ear/ mild-moderate hearing loss.

 

[d'Wooluf]

What we need for those with some hearing loss and tinnitus, is a way to preserve more residual hearing during implantation.

This is an interesting read:

Fusing Biology with the Bionic Ear

 

[lolkas]

This is an interesting read:

Fusing Biology with the Bionic Ear

They state in the article that there is restorative gene therapy available and it costs nearly $800k? Is that accurate? As far as we know, there isn't regenerative therapy available yet.

 

[d'Wooluf]

That gene therapy is for vision. They use that example to suggest that when gene therapy for hearing restoration becomes available, it may not come cheap.

I found the article hopeful because there are university trials in place as we speak. Loss of residual hearing is the main thing holding me back from getting a cochlear implant.

 

[Nick47]

Cochlear implant (CI) treatment is now established as a successful standard of care for auditory rehabilitation of profoundly deaf or severe hearing loss patients. CI candidates with tinnitus also benefit from improved health-related quality of life (HRQoL) and tinnitus burden. Current CI indications include bilateral (double-sided) profound hearing loss and deafness (DSD), unilateral (single-sided) deafness (SSD), and asymmetric hearing loss (AHL). The new and expanded indications for cochlear implants result in different healthcare situations, which may also be associated with differences in tinnitus burden before and after CI treatment. In this article, we discuss the prevalence of tinnitus in different patient groups and the influence of CI on tinnitus prevalence and severity in these groups. In addition, further therapeutic options for tinnitus suppression based on the CI principle are presented, including the development of an anti-tinnitus implant (proof of concept).

The full article is behind a paywall.

Cochlear Implant and Tinnitus

 

[annV]

The full article is behind a paywall.

Cochlear Implant and Tinnitus

Here's the full article, but it is in German. They only translated the abstract into English for PubMed use.

 

[Nick47]

Here's the full article, but it is in German. They only translated the abstract into English for PubMed use.

Thanks @annV. Are you a scientist or registered with an institution to get access? I wonder if we have any German members on Tinnitus Talk?

I was particularly interested in the anti-tinnitus implant!

 

[DeanD]

Here's the full article, but it is in German. They only translated the abstract into English for PubMed use.

Here's a translated to English version (all except page one which is image based instead of text, so more difficult to translate through a tool).

 

[Nick47]

Here's a translated to English version (all except page one which is image based instead of text, so more difficult to translate through a tool).

This is the Intakt project touching on extracochlear stimulation. Miles away and seemingly in no hurry.

 

[Nick47]

Cochlear implants for single-sided deafness and asymmetrical hearing loss:

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.

→ 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

 

[Nick47]

There is a wealth of literature already, but a trial specifically for tinnitus has begun.

It will include 50 patients and last 14 months. It is funded by Cochlear Europe in partnership with Nottingham Biomedical Research Centre.

→ New research to provide answers for cochlear implant patients with tinnitus

 

[AfroSnowman]

a trial specifically for tinnitus has begun.

It will include 50 patients and last 14 months. It is funded by Cochlear Europe in partnership with Nottingham Biomedical Research Centre.

I wish the study was about how to adjust cochlear implants to impact the sensation of tinnitus instead of just a survey about people's experiences.

 

[Nick47]

I wish the study was about how to adjust cochlear implants to impact the sensation of tinnitus instead of just a survey about people's experiences.

I was a bit underwhelmed to be honest. It's like we already know, so what is this for?

 

[AfroSnowman]

I was a bit underwhelmed to be honest. It's like we already know, so what is this for?

Well I guess it would be another confirmation point that may help justify further funding to explore that space. The other thing from the researcher's perspective is that this study is very inexpensive, easy to complete and publish. Folks publish or perish, right?