Comparison of Pseudobinaural Hearing to Real Binaural Hearing Rehabilitation After Cochlear Implantation in Patients With Unilateral Deafness and Tinnitus

Arndt, Susan; Aschendorff, Antje; Laszig, Roland; Beck, Rainer; Schild, Christian; Kroeger, Stefanie; Ihorst, Gabriele; Wesarg, Thomas

doi:10.1097/mao.0b013e3181fcf271

Cited by 432 publications

(566 citation statements)

References 22 publications

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“…The use of additional tinnitus suppression is possible [10], [11]. The preservation of the residual hearing ability in the context of high-frequency hearing loss allows the use of electroacoustic stimulation.…”

Section: Preconditionsmentioning

confidence: 99%

“…In cases of unilateral deafness, the cochlear implant may lead to a significant improvement of speech understanding in noise as well as directional hearing and tinnitus suppression. Early implantation in children may induce the development of binaural hearing [10], [11]. However, the hearing results of the implanted ear are poorer than of the normally hearing ear of the contralateral side.…”

Section: Bilateral Cochlea Implantationmentioning

confidence: 99%

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Cochlear Implant – State of the Art

2017

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Cochlear implants are the treatment of choice for auditory rehabilitation of patients with sensory deafness. They restore the missing function of Thomas Lenarz 1 inner hair cells by transforming the acoustic signal into electrical stimuli in the majority of patients including the use of the telephone. Children can achieve a near to normal speech and language development provided their deafness is detected early after onset and implantation is performed quickly thereafter. The diagnostic procedure as well as the surgical technique have been standardized and can be adapted to the individual anatomical and physiological needs both in children and adults. Special cases such as cochlear obliteration might require special measures and re-implantation, which can be done in most cases in a straight forward way. Technology upgrades count for better performance. Future developments will focus on better electrode-nerve interfaces by improving electrode technology. An increased number of electrical contacts as well as the biological treatment with regeneration of the dendrites growing onto the electrode will increase the number of electrical channels. This will give room for improved speech coding strategies in order to create the bionic ear, i.e. to restore the process of natural hearing by means of technology. The robot-assisted surgery will allow for high precision surgery and reliable hearing preservation. Biological therapies will support the bionic ear. Methods are bio-hybrid electrodes, which are coded by stem cells transplanted into the inner ear to enhance auto-production of neurotrophins. Local drug delivery will focus on suppression of trauma reaction and local regeneration. Gene therapy by nanoparticles will hopefully lead to the preservation of residual hearing in patients being affected by genetic hearing loss. Overall the cochlear implant is a very powerful tool to rehabilitate patients with sensory deafness. More than 1 million of candidates in Germany today could benefit from this high technology auditory implant. Only 50,000 are implanted so far. In the future, the procedure can be done under local anesthesia, will be minimally invasive and straight forward. Hearing preservation will be routine.Keywords: cochlear implant, sensory deafness, diagnostics, surgical procedure, results, complications, future developments SummaryCochlear implants are electronical stimulus prostheses for the functional replacement of the inner ear. Because of the rapid technical development and the good results, they could be established as standard therapy for sensory deafness. Cochlear implantation requires an interdisciplinary team and a quality-controlled concepts that reaches from the indication to the life-long control and that is fixed in the AWMF guideline on cochlear implant [1]. Current cochlear implant systems are partially implantable and equipped with a multitude of additional functions similar to hearing aids for sound pre-processing and noise elimination. The intracochlear position of the electrode allows fo...

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Section: Preconditionsmentioning

confidence: 99%

Section: Bilateral Cochlea Implantationmentioning

confidence: 99%

Cochlear Implant – State of the Art

2017

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“…Recently, cochlear implantation (CI) has been used in severe unilateral tinnitus patients with unilateral deafness. There is an 81%-95% improvement in tinnitus by CI in patients with SSD and uncontrolled tinnitus in the affected ear [4] . However, all participants do not experience the beneficial effects of CI, and an increase in tinnitus after CI has been reported.…”

Section: Introductionmentioning

confidence: 99%

“…Several recent studies suggest important benefits of cochlear implant regarding tinnitus [4] . However, cochlear implants have limitations, such as high cost and invasive surgery; and furthermore, there is not much evidence from studies on CI in patients with SSD.…”

Section: Ssdmentioning

confidence: 99%

Tinnitus Retraining Therapy in Unilateral Tinnitus Patients with Single Side Deafness

Kim

Byun²,

Park³

2016

Int Adv Otol

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OBJECTIVE:The purpose of this study was to evaluate the audiologic and clinical characteristics of the tinnitus in single-sided deafness (SSD) patients and to determine whether tinnitus retraining therapy (TRT) is beneficial to those patients who suffer from tinnitus with SSD. MATERIALS and METHODS:Thirty-six tinnitus patients with unilateral sensorineural profound hearing loss were included in the SSD group, and 46 tinnitus patients with normal hearing were included in the normal hearing group (NH group). Tinnitus evaluation consisted of the Tinnitus Handicap Inventory (THI), and visual analog scales (VAS) were obtained at the initial interview and 6 months after TRT. The therapeutic response was analyzed and compared between the two groups. RESULTS:The subjective intensity of tinnitus and objective loudness were greater in the SSD group. According to the THI scores prior to TRT, the SSD group showed significantly higher values, except in the emotional subscale. The THI score was significantly improved after TRT in both groups. The total THI score and all the subscale scores were significantly reduced. The VAS average scores were reduced from 6.5 to 5.1 in the SSD group, without statistical significance, whereas in the NH group, the VAS average scores significantly decreased from 5.8 to 4.5 after TRT. CONCLUSION:TRT was effective in SSD patients with subjective tinnitus.

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“…7 Unilateral, or "single-sided," deafness is another promising application for cochlear implants. 10 The goals are to restore the benefits of binaural hearing and potentially to suppress tinnitus. Here, the hazard is not losing hearing in the implanted ear.…”

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confidence: 99%

Cochlear implants: the hazards of unexpected success

Rubinstein

2012

CMAJ

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T hirty years ago, cochlear implants were in their infancy as research projects conducted at a handful of institutions around the world. The devices were crude, typically manufactured in a university or other noncommercial engineering laboratory, unapproved by any government regulatory agency, and implanted in experimental animals or humans for short periods. There was substantial skepticism, not only about the efficacy of the existing devices but also about the entire concept. It simply was not believable to many that such a device could ever functionally replace the complex and elegant biophysics of the cochlea. Pioneering implant surgeons were accused of performing unethical human studies. I was strongly encouraged, as were other interested students, to seek alternative, and putatively more rewarding, dissertation projects.Today, cochlear implants are a global commercial enterprise, with three major manufacturers and a few smaller entities developing or marketing these devices. Various implants are approved by government regulatory agencies across the developed world and are reimbursed to various degrees by commercial and government payors. Financial analysts now pay as much attention to the results of clinical trials of these devices as do clinicians. It is a new world for these remarkable devices because they represent a highly effective and cost-effective treatment 1 of severe-profound sensorineural hearing loss in both children and adults.It is now well established that prelingually deafened children (loss of hearing before speech begins) can develop near-normal levels of speech and language and achieve normal educational milestones when given an implant at an early age. Postlingually deaf adults, even octogenarians, 3 can usually speak on the telephone and, in some cases, achieve normal levels of speech understanding in quiet environments within a year of implantation. This level of success is beyond the wildest dreams of the pioneering engineers and clinicians. So what are the hazards? Implants previously underpromised and overdelivered. In an era in which patients were unable to understand speech with a hearing aid, any chance of improvement was welcome. Patients were warned that they might not benefit from an implant but would often proceed anyway because there was little risk associated with implanting a device in an ear that already had essentially no hearing. Even minimal postoperative speech perception would represent a substantial auditory benefit. As the devices improved over time, so did the risk-benefit ratio, at least for people with severe or total hearing loss.Today there are several quite promising nontraditional applications of implants that challenge this highly favourable risk-benefit analysis because they either involve implanting a device in a partly hearing ear or demand extremely high levels of performance from an ear with an implanted device (implanted ear) to provide benefit.Because speech discrimination with implants has improved dramatically, the criteria for implantation has ap...

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Comparison of Pseudobinaural Hearing to Real Binaural Hearing Rehabilitation After Cochlear Implantation in Patients With Unilateral Deafness and Tinnitus

Cited by 432 publications

References 22 publications

Cochlear Implant – State of the Art

Cochlear Implant – State of the Art

Tinnitus Retraining Therapy in Unilateral Tinnitus Patients with Single Side Deafness

Cochlear implants: the hazards of unexpected success

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