The Impact of Cochlear Implantation on Tinnitus, Stress and Quality of Life in Postlingually Deafened Patients

Abstract

Tinnitus is a common complaint in the candidates for cochlear implantation (CI). Tinnitus-related distress has often been measured in these patients using categorical ratings, which lack information about tinnitus severity, stress and health-related quality of life or their correlation. Here, using 4 validated questionnaires, we evaluated psychometric parameters and the quality of life of 32 postlingually deafened patients before and after CI. The data regarding pre-CI were collected retrospectively. Of all patients included in this study, 28 (87.5%) suffered from tinnitus before implantation. Following a mean of 24 months after surgery, these patients reported a significant decrease (39.2%) of tinnitus impairment, as measured by the Tinnitus Questionnaire. In none of the 28 patients has tinnitus worsened. Moreover, the 4 tinnitus-free patients remained so after the CI surgery. In addition, the implant supply resulted in 36.7% reduction in perceived stress and in 15.4% reduction in evasive coping. In addition, the focus on positive coping has improved by 12.3%, whereas the health-related quality of life improved by 53.4% in all patients. Tinnitus impairment and stress were reduced more strongly in patients who had initially higher scores. Interestingly, a significant correlation between the psychometric scores was found mainly after CI. Our results indicate that patients with higher tinnitus-related distress have a lower quality of life, lesser coping abilities and perceive more stress, but before implantation it is masked by deafness. We conclude that tinnitus-related screening of patients before and after CI is an important step in the identification of individuals who would benefit from specific fitting and/or tinnitus therapy after implantation.

Extra Benefit of a Second Cochlear Implant With Respect to Health-Related Quality of Life and Tinnitus

“…The possibility of lower tinnitus annoyance being linked to the increased quality of life also was shown in our recent study of 32 unilaterally implanted patients (18). Correlation analysis revealed that the extent of tinnitus annoyance after CI has a negative influence on stress perception and the HRQoL.…”

“…Recently, we reported that in addition to improved hearing and speech understanding, unilaterally implanted patients have suppression of tinnitus, perceive less stress, and have increased quality of life. In addition, significant inverse correlations were found between tinnitus-related distress and the health-related quality of life (HRQoL) after unilateral CI supply (18).…”

Tinnitus Suppression by Intracochlear Electrical Stimulation in Single-Sided Deafness: A Prospective Clinical Trial - Part I

“…However, the current study investigated the possibility of suppressing tinnitus with looped electrical stimulation in subjects with clearly lateralized tinnitus to the deaf ear, and the periphery of the deaf ear in the studied population seems to be the same as for the 'conventional' bilaterally deaf population. The similarity between the deaf ear in the SSD population and in the bilaterally deaf population is supported by comparable outcomes of the standard clinical CI between these populations on for example electric dynamic ranges, pitch saturation limit, speech perception and tinnitus [Firszt et al, 2012a;Olze et al, 2012;Vermeire and Lawson, 2012;Schatzer et al, 2014].…”

“…Almost two centuries later, House [1976] reported tinnitus suppression in one of the first cochlear implant (CI) patients. Although the primary goal of cochlear implantation is to provide a sense of sound to a person who suffers from severe to profound hearing loss, during decades of research it has become clear that tinnitus suppression is a common side effect [Ito and Sakakihara, 1994;Aschendorff et al, 1998;House, 1999;Steenerson and Cronin, 1999;Ruckenstein et al, 2001;Miyamoto and Bichey, 2003;Di Nardo et al, 2007;Tyler et al, 2008;Olze et al, 2011Olze et al, , 2012de Carvalho et al, 2013]. Nevertheless, tinnitus can also be a complication after cochlear implantation [Di Nardo et al, 2007;Postelmans et al, 2007;Hou et al, 2010], possibly related to cochlear damage due to the surgery [Nordfalk et al, 2014;Todt et al, 2014].…”

A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant

“…CIs have been shown to reduce tinnitus in about 80% of the patients presenting with tinnitus (Demajumdar, Stoddart, Donaldson, & Proops, 1999;Gibson, 1992;Harris, Parker, Fields, Frewin, & Baguley, 2011;Ito, 1997;Ito & Sakakihara, 1994a, 1994bKloostra, Arnold, Hofman, & Van Dijk, 2015;Kompis et al, 2012;Mo, Harris, & Lindbaek, 2002;Olze et al, 2011;Olze, Grabel, et al, 2012;Olze, Szczepek, et al, 2012;Quaranta, Wagstaff, & Baguley, 2004;Souliere, Kileny, Zwolan, & Kemink, 1992;Tyler, 1994Tyler, , 1995Tyler & Kelsay, 1990;Van de Heyning et al, 2008;Yonehara et al, 2006). Pan et al (2009) administered the Tinnitus Handicap Questionnaire (Kuk, Tyler, Russell, & Jordan, 1990) to tinnitus sufferers before and after they received a CI and observed that scores on the Tinnitus Handicap Questionnaire reduced for most patients.…”