A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individuals

Abstract Background Cochlear implants have helped over one million individuals restore functional hearing globally, but their clinical utility in suppressing tinnitus has not been firmly established. Methods In a decade-long study, we examined longitudinal effects of cochlear implants on tinnitus in...

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Main Authors: Qian Wang, Michelle R. Kapolowicz, Jia-Nan Li, Fei Ji, Wei-Dong Shen, Fang-Yuan Wang, Wei Chen, Wei-Wei Guo, Chi Zhang, Ri-Yuan Liu, Miao Zhang, Meng-Di Hong, Ai-Ting Chen, Fan-Gang Zeng, Shi-Ming Yang
Format: Article
Language:English
Published: Nature Portfolio 2024-12-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-024-00692-8
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author Qian Wang
Michelle R. Kapolowicz
Jia-Nan Li
Fei Ji
Wei-Dong Shen
Fang-Yuan Wang
Wei Chen
Wei-Wei Guo
Chi Zhang
Ri-Yuan Liu
Miao Zhang
Meng-Di Hong
Ai-Ting Chen
Fan-Gang Zeng
Shi-Ming Yang
author_facet Qian Wang
Michelle R. Kapolowicz
Jia-Nan Li
Fei Ji
Wei-Dong Shen
Fang-Yuan Wang
Wei Chen
Wei-Wei Guo
Chi Zhang
Ri-Yuan Liu
Miao Zhang
Meng-Di Hong
Ai-Ting Chen
Fan-Gang Zeng
Shi-Ming Yang
author_sort Qian Wang
collection DOAJ
description Abstract Background Cochlear implants have helped over one million individuals restore functional hearing globally, but their clinical utility in suppressing tinnitus has not been firmly established. Methods In a decade-long study, we examined longitudinal effects of cochlear implants on tinnitus in 323 post-lingually deafened individuals including 211 with pre-existing tinnitus and 112 without tinnitus. The primary endpoints were tinnitus loudness and tinnitus handicap inventory. The secondary endpoints were speech recognition, anxiety and sleep quality. Results Here we show that after 24 month implant usage, the tinnitus cohort experience 58% reduction in tinnitus loudness (on a 0–10 scale from 4.3 baseline to 1.8 = −2.5, 95% CI: −2.7 to −2.2, p = 3 x 10−6; effect size d’ = −1.4,) and 44% in tinnitus handicap inventory (=−21.2, 95% CI: −24.5 to −17.9, p = 1 x 10−15; d’=−1.0). Conversely, only 3.6% of those without pre-existing tinnitus develop it post-implantation. Prior to implantation, the tinnitus cohort have lower speech recognition, higher anxiety and poorer sleep quality than the non-tinnitus cohort, measured by Mandarin monosyllabic words, Zung Self-rating Anxiety Scale and Pittsburgh Sleep Quality Index, respectively. Although the 24 month implant usage eliminate the group difference in speech and anxiety measures, the tinnitus cohort still face significant sleep difficulties likely due to the tinnitus coming back when the device was inactive at night. Conclusions The present result shows that cochlear implantation can offer an alternative effective treatment for tinnitus. The present result also identifies a critical need in developing always-on and atraumatic devices for tinnitus patients, including potentially those with normal hearing.
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spelling doaj-art-914c8eea80e740f08addf29dca3a89002025-08-20T01:57:12ZengNature PortfolioCommunications Medicine2730-664X2024-12-01411910.1038/s43856-024-00692-8A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individualsQian Wang0Michelle R. Kapolowicz1Jia-Nan Li2Fei Ji3Wei-Dong Shen4Fang-Yuan Wang5Wei Chen6Wei-Wei Guo7Chi Zhang8Ri-Yuan Liu9Miao Zhang10Meng-Di Hong11Ai-Ting Chen12Fan-Gang Zeng13Shi-Ming Yang14Senior Department of Otolaryngology-Head and Neck Surgery, the First Medical Center of PLA General HospitalCenter for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology—Head and Neck Surgery, University of California Irvine, IrvineSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the First Medical Center of PLA General HospitalSenior Department of Otolaryngology-Head and Neck Surgery, the First Medical Center of PLA General HospitalCenter for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology—Head and Neck Surgery, University of California Irvine, IrvineSenior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General HospitalAbstract Background Cochlear implants have helped over one million individuals restore functional hearing globally, but their clinical utility in suppressing tinnitus has not been firmly established. Methods In a decade-long study, we examined longitudinal effects of cochlear implants on tinnitus in 323 post-lingually deafened individuals including 211 with pre-existing tinnitus and 112 without tinnitus. The primary endpoints were tinnitus loudness and tinnitus handicap inventory. The secondary endpoints were speech recognition, anxiety and sleep quality. Results Here we show that after 24 month implant usage, the tinnitus cohort experience 58% reduction in tinnitus loudness (on a 0–10 scale from 4.3 baseline to 1.8 = −2.5, 95% CI: −2.7 to −2.2, p = 3 x 10−6; effect size d’ = −1.4,) and 44% in tinnitus handicap inventory (=−21.2, 95% CI: −24.5 to −17.9, p = 1 x 10−15; d’=−1.0). Conversely, only 3.6% of those without pre-existing tinnitus develop it post-implantation. Prior to implantation, the tinnitus cohort have lower speech recognition, higher anxiety and poorer sleep quality than the non-tinnitus cohort, measured by Mandarin monosyllabic words, Zung Self-rating Anxiety Scale and Pittsburgh Sleep Quality Index, respectively. Although the 24 month implant usage eliminate the group difference in speech and anxiety measures, the tinnitus cohort still face significant sleep difficulties likely due to the tinnitus coming back when the device was inactive at night. Conclusions The present result shows that cochlear implantation can offer an alternative effective treatment for tinnitus. The present result also identifies a critical need in developing always-on and atraumatic devices for tinnitus patients, including potentially those with normal hearing.https://doi.org/10.1038/s43856-024-00692-8
spellingShingle Qian Wang
Michelle R. Kapolowicz
Jia-Nan Li
Fei Ji
Wei-Dong Shen
Fang-Yuan Wang
Wei Chen
Wei-Wei Guo
Chi Zhang
Ri-Yuan Liu
Miao Zhang
Meng-Di Hong
Ai-Ting Chen
Fan-Gang Zeng
Shi-Ming Yang
A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individuals
Communications Medicine
title A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individuals
title_full A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individuals
title_fullStr A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individuals
title_full_unstemmed A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individuals
title_short A prospective cohort study of cochlear implantation as a treatment for tinnitus in post-lingually deafened individuals
title_sort prospective cohort study of cochlear implantation as a treatment for tinnitus in post lingually deafened individuals
url https://doi.org/10.1038/s43856-024-00692-8
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