Analysis of a Cochlear Implant Database: Changes in Tinnitus Prevalence and Distress After Cochlear Implantation

Abstract

The aim of this study was to estimate the prevalence and distress of tinnitus pre- and post-cochlear implantation in patients with bilateral severe to profound hearing loss. In this retrospective study, we included patients from a cochlear implant clinic in Perth, Western Australia. Pre- and post-cochlear implantation data from 300 implant recipients were collected on self-reported presence of tinnitus, tinnitus distress using the Tinnitus Reaction Questionnaire (TRQ), hearing-related quality of life using the Abbreviated Profile of Hearing Aid Benefit (APHAB), and consonant-nucleus vowel-consonant (CNC) word recognition test scores. Retrospectively, patients were grouped into those with or without tinnitus, and the grade of tinnitus distress. The potential factors associated with post-implantation changes in the presence of tinnitus and its distress were evaluated. Tinnitus prevalence was 55.8% pre-operatively and 44.3% post-implantation with a median TRQ score respectively of 12.0 (IQR: 1.0–28.0) and 3.5 (IQR: 0.0–16.2) points. Among the 96 patients experiencing tinnitus pre-implantation, 14.6% patients experienced moderate to catastrophic tinnitus distress pre-implantation compared to 6.3% post-implantation. To conclude, the pre- and post-implantation median TRQ score for the cohort population showed that tinnitus was a “slight” handicap. Tinnitus prevalence and its associated tinnitus distress decreased post-implantation. Patients with tinnitus post-implantation were significantly younger and had less severe pre-implantation hearing loss in the non-implanted ear than patients without tinnitus. Further research is needed to understand the factors influencing changes in tinnitus.

Effects of auditory rehabilitation with cochlear implant on tinnitus prevalence and distress, health-related quality of life, subjective hearing and psychological comorbidities: Comparative analysis of patients with asymmetric hearing loss (AHL), double-sided (bilateral) deafness (DSD), and single-sided (unilateral) deafness (SSD)

“…In a sample of 51 DSD patients, 94.1% of CI candidates had preoperative tinnitus ( 46 ). In other studies, the prevalence of tinnitus in DSD patients was 42% ( 21 ) and 55.8% ( 47 ), which is comparable to our results. The majority of data regarding tinnitus incidence in severe and profoundly deaf people originates from the field of cochlear implant, and the subjects included in the research were verified CI candidates.…”

The impact of tinnitus on adult cochlear implant recipients: A mixed-method approach

“…Different degrees of tinnitus awareness and annoyance were reported by participants, ranging from aware but not bothered to always bothered in the discussion forum. This heterogeneity in tinnitus annoyance has also been raised by studies analyzing large databases of CI users, where tinnitus was not a relevant problem in more than 70% of CI users with tinnitus, a moderate problem in around 20% of CI users with tinnitus and a severe or worse problem is less than 10% of CI users [ 10 , 15 ]. Participants did not all report the same difficulties as some had no difficulties associated with tinnitus where others reported several.…”

“…However, this effect seems to be patient specific as the other 70% of participants did not report total suppression of tinnitus when wearing their sound processor. Previous studies have shown that electrical stimulation can still reduce tinnitus impact in CI recipients even if it does not completely suppress their tinnitus [ 10 , 18 , 19 ]. In the current survey, this was assessed using two questions distinguishing tinnitus impact when wearing the sound processor and while not wearing it.…”

“…While the primary purpose of cochlear implantation is to restore hearing, systematic reviews showed that tinnitus reduction can be a secondary beneficial effect [ 7 – 9 ]. However, the effect of implantation seems to vary widely between patients, ranging from total tinnitus suppression to tinnitus induction in up to 9% of CI users [ 6 , 10 ]. Recent studies compared tinnitus presence pre- and post-implantation in patients receiving a cochlear implant for severe to profound hearing and showed that tinnitus prevalence decreased post-implantation [ 10 – 13 ].…”

“…However, the effect of implantation seems to vary widely between patients, ranging from total tinnitus suppression to tinnitus induction in up to 9% of CI users [ 6 , 10 ]. Recent studies compared tinnitus presence pre- and post-implantation in patients receiving a cochlear implant for severe to profound hearing and showed that tinnitus prevalence decreased post-implantation [ 10 – 13 ]. In these studies, between 34% and 53% of cochlear implant (CI) users still experienced tinnitus after implantation [ 10 – 13 ] and only between 4% and 25% experienced it as a moderate to severe handicap [ 14 – 16 ].…”