Abstract
Electrical stimulation with cochlear implants is able to significantly suppress the tinnitus sensations in 25–72% of implanted patients. Up to this point, no clear predictors for the effectiveness of tinnitus suppression with cochlear implants have been found and this substantially limits the possibility of the application of cochlear implants for this purpose. The objective of the study was to investigate if a trial electrical round window stimulation (RWS) could be used as a diagnostic tool for identifying candidates in whom electrical stimulation would be successful as treatment for tinnitus. Thirty-four patients with unilateral severe tinnitus and ipsilateral moderate to severe sensorineural hearing loss underwent a trial RWS under local anesthesia. Thirteen patients received a cochlear implant. All patients qualified for cochlear implantation on the basis of the trial RWS showed tinnitus suppression with the implant switched on. Complete or almost complete tinnitus suppression was obtained in 77% and partial in 23%. The mean tinnitus loudness reduction was 68% (VAS score reduction from 7.7 to 2.5). False negative results are estimated not to exceed 10–15%. We conclude that significant tinnitus suppression achieved during trial RWS under local anesthesia is a simple procedure allowing the efficient identification of candidates in whom electrical stimulation with a cochlear implant would be successful as treatment for intractable tinnitus.
Highlights
Tinnitus is the perception of sound that does not arise from an external source
The exact pathophysiology of tinnitus is unknown, but in the case of associated sensorineural hearing loss, it is assumed that auditory deprivation results in pathologic reorganization and altered activity of the neural elements of the auditory pathway
This study investigated if a trial round window stimulation (RWS) could act as a reliable diagnostic tool for identifying candidates in whom electrical stimulation would be successful as treatment for tinnitus
Summary
Tinnitus is the perception of sound that does not arise from an external source. It is described by patients as a “whistle” or “beep” sound or sounds such as “crickets” and “noise” and many others. The exact pathophysiology of tinnitus is unknown, but in the case of associated sensorineural hearing loss, it is assumed that auditory deprivation results in pathologic reorganization and altered activity of the neural elements of the auditory pathway. There is a wide range of treatment modalities for tinnitus, but no single therapy is effective in all patients. Treatment options range from different medications and surgical approaches, external noise generators or hearing aids to psychotherapy and alternative therapies. For patients with severe and profound hearing loss, the only potentially effective treatment modality is electrical stimulation, which has gained interest over the past few decades
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