Tinnitus Burden Predicts Domain-Specific Quality of Life After Cochlear Implantation

Objective: To evaluate the longitudinal association between tinnitus burden and domain-specific cochlear implant-related quality of life in adult cochlear implant recipients. Study design: Retrospective chart review. Setting: Single academic tertiary-care center. Patients: One hundred eighty-one adult cochlear implant recipients (aged 19-91 y; mean 61.4±17.5). Interventions: Quality of life questionnaires. Main outcome measures: Tinnitus Handicap Inventory (THI) and Cochlear Implant Quality of Life instruments (CIQOL-35 Profile and CIQOL-10 Global) were assessed preoperatively and at 6 and 12 months postoperatively. Results: Following implantation, tinnitus severity decreased and CI-specific quality of life improved across all CIQOL domains by 6 months and remained stable at 12 months. In adjusted linear mixed-effects models (n=128), greater persistent tinnitus burden was independently associated with poorer CI-specific quality of life across multiple domains, including Emotional, Social, Entertainment, Communication, Listening Effort, and Global Functioning. The strongest association was observed in the Emotional domain (β=−2.17 per 10-point increase in THI). These findings remained directionally consistent in sensitivity analyses adjusting for baseline clinical characteristics and postoperative speech performance. Conclusions: Cochlear implantation improves both tinnitus severity and cochlear implant-specific quality of life. However, persistent tinnitus burden remains independently associated with poorer patient-reported outcomes across multiple domains, particularly in emotional functioning.