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Tinnitus Suppression Following Cochlear Implantation: A Multifactorial Investigation

Tinnitus Suppression Following Cochlear Implantation: A Multifactorial Investigation Abstract • The effects of cochlear implant on loudness, annoyance, daily duration, location, and residual inhibition of tinnitus were evaluated by a closed-ended, quantifiable questionnaire in 33 postlingually deafened patients who had received implants at the University of Michigan, Ann Arbor, between 1986 and 1990. Preoperative tinnitus was present in 85% of patients. A statistical comparison of preoperative vs postoperative loudness and annoyance indicated a significant reduction in both of these complaints postoperatively. Loudness and annoyance were significantly correlated, both preoperatively and postoperatively. Fifteen patients (54%) with preoperative tinnitus demonstrated a loudness decrease of 30% or more; 43% demonstrated an annoyance decrease of 30% or more; and 48% demonstrated a decrease of 30% or more in daily tinnitus duration. Patients who experienced a loudness or annoyance decrease of 30% or more after implantation demonstrated significantly higher preoperative levels of these complaints, suggesting that degree of tinnitus reduction after implantation may be related to preoperative loudness and annoyance levels. Contralateral tinnitus suppression was reported by 42% of patients. Residual inhibition ranging from 60 seconds to several hours was reported by 50% of patients, predominantly in the ear with the implant. Age, gender, cause of hearing loss, duration of tinnitus, cochlear implant usage, and time after implantation were not predictive of tinnitus suppression. Overall, the majority of the patients (74%) thought that their cochlear implant was helpful in tinnitus suppression, especially in the ear with the implant. Contralateral residual inhibition and tinnitus suppression suggest a central mechanism contributing to these phenomena. (Arch Otolaryngol Head Neck Surg. 1992;118;1291-1297) References 1. Stouffer JL, Tyler RS. Characterization of tinnitus by tinnitus patients . J Hearing Speech Dis. 1990;55:439-453. 2. Doyle PJ, Sipke P, Doyle I, Martin-Burns V. Management of tinnitus: a practical approach . J Otolaryngol. 1987;16:127-132. 3. House JW. Tinnitus: evaluation and treatment . Am J Otol. 1984;5:472-475. 4. Pulec JL. Tinnitus: surgical therapy . Am J Otol. 1984;5:479-480. 5. Kuk FK, Tyler RS, Rustad N, Harker LA, Tye-Murray N. Alternating current at the eardrum for tinnitus reduction . J Speech Hearing Res. 1989;32:393-400. 6. Hazell JWP, Meerton LJ, Conway MJ. Electrical tinnitus suppression (ETS) with a single channel cochlear implant . J Laryngol Otol. 1989;18( (suppl) ): 39-44. 7. Rothera M, Conway M, Brightwell A, Graham J. Evaluation of patients for cochlear implant by promontory stimulation . Br J Audiol. 1986;20:25-28.Crossref 8. Tyler RS, Kelsay D. Advantages and disadvantages reported by some of the better cochlear implant patients . Am J Otol. 1990;11:282-289. 9. Dobie RA, Sakai C, Sullivan M, Katon WJ, Russo J. Measures of tinnitus treatment efficacy: results of a randomized clinical trial of nortriptyline. In: Program and abstracts of the 15th Midwinter Research Meeting of the Association for Research in Otolaryngology; February 2-6, 1992; St Petersburg Beach, Fla. 10. Balkany T, Bantli H. Workshop: direct electrical stimulation of the inner ear for the relief of tinnitus . Am J Otol. 1987;8:207-212. 11. Shulman A. External electrical tinnitus suppression: a review . Am J Otol. 1987;8:479-484. 12. Thedinger B, House WF, Edgerton BJ. Cochlear implant for tinnitus: case reports . Ann Otol Rhinol Laryngol. 1985;94:10-13. 13. Terry AMP, Jones DM, Davis BR, Slater R. Parametric studies of tinnitus masking and residual inhibition . Br J Audiol. 1983;17:245-256.Crossref 14. Hazell JWP, Wood SM, Cooper HR, et al. A clinical study of tinnitus maskers . Br J Audiol. 1985;19:65-146.Crossref 15. Erlandsson S, Ringdahl A, Hutchins T, Carlsson SG. Treatment oftinnitus: a controlled comparison of masking and placebo . Br J Audiol. 1987;21:37-44.Crossref 16. Feldmann H. Homolateral and contralateral masking of tinnitus . J Laryngol Otol. 1981;4( (suppl) ):60-70. 17. Hazell JWP, Williams GR, Sheldrake JB. Tinnitus maskers: successes and failures: a report of the state of the art . J Laryngol Otol. 1981;4( (suppl) ):80-87. 18. Terry AMP, Jones DM. Preference for potential tinnitus maskers: results from annoyance ratings . Br J Audiol. 1986;20:277-297.Crossref 19. Penner MJ. Masking of tinnitus and central masking . J Speech Hearing Res. 1987;30:147-152.Crossref 20. Penner MJ. Judgements and measurements of the loudness of tinnitus before and after masking . J Speech Hearing Dis. 1988;31:582-587. 21. Penner MJ. Adaptation and the masking of tinnitus . J Speech Hearing Res. 1989;32:339-346. 22. Berliner RI, Cunningham JK, House WF, House J. Effect of the cochlear implant on tinnitus in profoundly deaf patients . In: Feldman H, ed. Proceedings of the Third International Tinnitus Seminar . Munster, Germany: Karlsuhe Harsh; 1987:451-453. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Tinnitus Suppression Following Cochlear Implantation: A Multifactorial Investigation

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References (24)

Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1992.01880120017004
Publisher site
See Article on Publisher Site

Abstract

Abstract • The effects of cochlear implant on loudness, annoyance, daily duration, location, and residual inhibition of tinnitus were evaluated by a closed-ended, quantifiable questionnaire in 33 postlingually deafened patients who had received implants at the University of Michigan, Ann Arbor, between 1986 and 1990. Preoperative tinnitus was present in 85% of patients. A statistical comparison of preoperative vs postoperative loudness and annoyance indicated a significant reduction in both of these complaints postoperatively. Loudness and annoyance were significantly correlated, both preoperatively and postoperatively. Fifteen patients (54%) with preoperative tinnitus demonstrated a loudness decrease of 30% or more; 43% demonstrated an annoyance decrease of 30% or more; and 48% demonstrated a decrease of 30% or more in daily tinnitus duration. Patients who experienced a loudness or annoyance decrease of 30% or more after implantation demonstrated significantly higher preoperative levels of these complaints, suggesting that degree of tinnitus reduction after implantation may be related to preoperative loudness and annoyance levels. Contralateral tinnitus suppression was reported by 42% of patients. Residual inhibition ranging from 60 seconds to several hours was reported by 50% of patients, predominantly in the ear with the implant. Age, gender, cause of hearing loss, duration of tinnitus, cochlear implant usage, and time after implantation were not predictive of tinnitus suppression. Overall, the majority of the patients (74%) thought that their cochlear implant was helpful in tinnitus suppression, especially in the ear with the implant. Contralateral residual inhibition and tinnitus suppression suggest a central mechanism contributing to these phenomena. (Arch Otolaryngol Head Neck Surg. 1992;118;1291-1297) References 1. Stouffer JL, Tyler RS. Characterization of tinnitus by tinnitus patients . J Hearing Speech Dis. 1990;55:439-453. 2. Doyle PJ, Sipke P, Doyle I, Martin-Burns V. Management of tinnitus: a practical approach . J Otolaryngol. 1987;16:127-132. 3. House JW. Tinnitus: evaluation and treatment . Am J Otol. 1984;5:472-475. 4. Pulec JL. Tinnitus: surgical therapy . Am J Otol. 1984;5:479-480. 5. Kuk FK, Tyler RS, Rustad N, Harker LA, Tye-Murray N. Alternating current at the eardrum for tinnitus reduction . J Speech Hearing Res. 1989;32:393-400. 6. Hazell JWP, Meerton LJ, Conway MJ. Electrical tinnitus suppression (ETS) with a single channel cochlear implant . J Laryngol Otol. 1989;18( (suppl) ): 39-44. 7. Rothera M, Conway M, Brightwell A, Graham J. Evaluation of patients for cochlear implant by promontory stimulation . Br J Audiol. 1986;20:25-28.Crossref 8. Tyler RS, Kelsay D. Advantages and disadvantages reported by some of the better cochlear implant patients . Am J Otol. 1990;11:282-289. 9. Dobie RA, Sakai C, Sullivan M, Katon WJ, Russo J. Measures of tinnitus treatment efficacy: results of a randomized clinical trial of nortriptyline. In: Program and abstracts of the 15th Midwinter Research Meeting of the Association for Research in Otolaryngology; February 2-6, 1992; St Petersburg Beach, Fla. 10. Balkany T, Bantli H. Workshop: direct electrical stimulation of the inner ear for the relief of tinnitus . Am J Otol. 1987;8:207-212. 11. Shulman A. External electrical tinnitus suppression: a review . Am J Otol. 1987;8:479-484. 12. Thedinger B, House WF, Edgerton BJ. Cochlear implant for tinnitus: case reports . Ann Otol Rhinol Laryngol. 1985;94:10-13. 13. Terry AMP, Jones DM, Davis BR, Slater R. Parametric studies of tinnitus masking and residual inhibition . Br J Audiol. 1983;17:245-256.Crossref 14. Hazell JWP, Wood SM, Cooper HR, et al. A clinical study of tinnitus maskers . Br J Audiol. 1985;19:65-146.Crossref 15. Erlandsson S, Ringdahl A, Hutchins T, Carlsson SG. Treatment oftinnitus: a controlled comparison of masking and placebo . Br J Audiol. 1987;21:37-44.Crossref 16. Feldmann H. Homolateral and contralateral masking of tinnitus . J Laryngol Otol. 1981;4( (suppl) ):60-70. 17. Hazell JWP, Williams GR, Sheldrake JB. Tinnitus maskers: successes and failures: a report of the state of the art . J Laryngol Otol. 1981;4( (suppl) ):80-87. 18. Terry AMP, Jones DM. Preference for potential tinnitus maskers: results from annoyance ratings . Br J Audiol. 1986;20:277-297.Crossref 19. Penner MJ. Masking of tinnitus and central masking . J Speech Hearing Res. 1987;30:147-152.Crossref 20. Penner MJ. Judgements and measurements of the loudness of tinnitus before and after masking . J Speech Hearing Dis. 1988;31:582-587. 21. Penner MJ. Adaptation and the masking of tinnitus . J Speech Hearing Res. 1989;32:339-346. 22. Berliner RI, Cunningham JK, House WF, House J. Effect of the cochlear implant on tinnitus in profoundly deaf patients . In: Feldman H, ed. Proceedings of the Third International Tinnitus Seminar . Munster, Germany: Karlsuhe Harsh; 1987:451-453.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Dec 1, 1992

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