title: Cochlear implants as a treatment option for unilateral hearing loss, severe tinnitus and hyperacusis.
abstract: Tinnitus is an incapacitating condition commonly affecting cochlear implant (CI) candidates. The aim of this clinical study is to assess the long-term effects of CI treatment in patients with severe-to-profound, sensorineural, unilateral hearing loss (UHL) and incapacitating tinnitus. We performed a prospective Cochlear™ company-sponsored multicentre study in five Spanish centres. Sixteen patients with UHL and incapacitating tinnitus, which was indicated by a Tinnitus Handicap Inventory (THI) score >58%, received a Nucleus® CI in their deaf ear. The study design includes repeated within-subject measures on hearing, tinnitus, hyperacusis and quality of life up to 12 months after initial CI fitting. In addition to hearing loss and tinnitus, all patients suffered from hyperacusis. Most patients had a sudden hearing loss and received a CI within 2 years after their hearing loss. Preliminary 6-month, post-CI activation data of 13 subjects showed that the majority of patients perceived a subjective benefit from CI treatment, which was assessed using the THI, a Visual Analogue Scale of tinnitus loudness/annoyance and the Speech, Spatial and Qualities of Hearing Scale. Preliminary 12-month data of 7 subjects showed that most patients also perceived a degree of relief from their hyperacusis. One patient showed no improvements in any of the applied scales, which could be explained by partial insertion of the electrode due to obstruction of the cochlea by otosclerosis. In conclusion, CI can successfully be used in the treatment of UHL patients with accompanying severe tinnitus and hyperacusis. Implantation resulted in hearing benefits and a durable relief from tinnitus and hyperacusis in the majority of patients. These findings support the hypothesis that pathophysiological mechanisms after peripheral sensorineural hearing loss are at least partly reversible when hearing is restored with a CI.
authors.affiliation: Unidad de Hipoacusia, Servicio de Otorrinolaringología, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Ramos Macías
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Falcón González
authors.forename: Manuel
authors.initials: M
authors.lastname: Manrique
authors.forename: Constantino
authors.initials: C
authors.lastname: Morera
authors.forename: Luis
authors.initials: L
authors.lastname: García-Ibáñez
authors.forename: Carlos
authors.initials: C
authors.lastname: Cenjor
authors.forename: Chrystellel
authors.initials: C
authors.lastname: Coudert-Koall
authors.forename: Matthijs
authors.initials: M
authors.lastname: Killian
mesh_terms: D000328:Adult; D000368:Aged; D019929:Cochlear Implantation; D003054:Cochlear Implants; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000534:rehabilitation*; D003639:Hearing Loss, Sudden / Q000150:complications / Q000534:rehabilitation; D046088:Hearing Loss, Unilateral / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D012001:Hyperacusis / Q000150:complications / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D014012:Tinnitus / Q000150:complications / Q000534:rehabilitation*; D016896:Treatment Outcome