title: Tinnitus Suppression by Intracochlear Electrical Stimulation in Single-Sided Deafness: A Prospective Clinical Trial - Part I.
abstract: Cochlear implantation is a viable treatment option for tinnitus, but the underlying mechanism is yet unclear. Is the tinnitus suppression due to the reversal of the assumed maladaptive neuroplasticity or is it the shift in attention from the tinnitus to environmental sounds and therefore a reduced awareness that reduces tinnitus perception? In this prospective trial, 10 patients with single-sided deafness were fitted with a cochlear implant to investigate the effect of looped intracochlear electrical stimulation (i.e. stimulation that does not encode environmental sounds) on tinnitus, in an effort to find optimal stimulation parameters. Variables under investigation were: amplitude (perceived stimulus loudness), anatomical location inside the cochlea (electrode/electrodes), amplitude modulation, polarity (cathodic/anodic first biphasic stimulation) and stimulation rate. The results suggest that tinnitus can be reduced with looped electrical stimulation, in some cases even with inaudible stimuli. The optimal stimuli for tinnitus suppression appear to be subject specific. However, medium-to-loud stimuli suppress tinnitus significantly better than soft stimuli, which partly can be explained by the masking effect. Although the long-term effects on tinnitus would still have to be investigated and will be described in part II, intracochlear electrical stimulation seems a potential treatment option for tinnitus in this population.
authors.affiliation: Department of ENT/Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Remo A G J
authors.initials: RA
authors.lastname: Arts
authors.forename: Erwin L J
authors.initials: EL
authors.lastname: George
authors.forename: Andreas
authors.initials: A
authors.lastname: Griessner
authors.forename: Clemens
authors.initials: C
authors.lastname: Zierhofer
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stokroos
mesh_terms: D000328:Adult; D000368:Aged; D019929:Cochlear Implantation; D003054:Cochlear Implants; D004599:Electric Stimulation Therapy; D005260:Female; D046088:Hearing Loss, Unilateral / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014012:Tinnitus / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome