Cochlear implantation as a durable tinnitus treatment in single-sided deafness

INTRODUCTION: Severe tinnitus can seriously impair patients in their activities in daily life and reduce their quality of life. The aims of this prospective clinical study were to assess the long-term effects of cochlear implantation (CI) on tinnitus in patients with single-sided deafness and ipsilateral incapacitating tinnitus, and to investigate whether CI could treat various types of tinnitus. MATERIALS AND METHODS: Twenty-six subjects with unilateral severe-to-profound sensorineural hearing loss received a CI. Patients suffered from severe tinnitus greater than 6/10 on a visual analogue scale (VAS) due to unilateral deafness. Assessment consisted of a tinnitus analysis including determination of tinnitus type, frequency, and loudness. A tinnitus questionnaire (TQ) measured tinnitus distress. VAS and TQ were administered pre-implantation and post-implantation. RESULTS: All 26 patients reported a subjective benefit from CI. Tinnitus loudness reduced significantly after CI from 8.6 to 2.2 on the VAS (scale: 0-10). The TQ total score decreased significantly and the mean tinnitus degree decreased from severe to mild. No differences were observed between patients with pure-tone tinnitus, narrow band noise tinnitus, or polyphonic tinnitus. The degree of tinnitus loudness reduction remained stable after CI. CONCLUSIONS: CI can successfully be used as treatment of severe tinnitus in patients with single-sided deafness and is equally effective for pure tone, narrow band noise, and polyphonic tinnitus. Long-term results show that implantation provides durable tinnitus relief in these patients. These results support the hypothesis that physiopathological mechanisms after peripheral deafferentation are reversible when hearing is restored. Single-sided deafness accompanied by severe tinnitus is a new indication for CI.