Effectiveness of physiatric therapy for somatosensory tinnitus in cochlear implant recipients following severe sudden sensorineural hearing loss

Tinnitus, defined as the perception of sound in the absence of an external auditory stimulus, is a symptom frequently observed across different population groups. Its prevalence among adults is relatively high, affecting approximately 15% of individuals, and it significantly interferes with daily activities and quality of life in 5%–10% of patients. Although its pathophysiology has not yet been fully elucidated, tinnitus is believed to result from maladaptive cortical plasticity associated with anatomical and functional alterations within neural networks of both auditory and nonauditory systems related to hearing. Furthermore, the somatosensory, limbic, and autonomic nervous systems are also involved in the development and modulation of tinnitus. Tinnitus may be influenced by somatosensory input originating from the cervical spine and temporomandibular region; in such cases, it is referred to as somatic or somatosensory tinnitus (ST). ST is triggered by movements of the head, neck, jaw, or eyes that modify auditory neural pathways through somatic influences. The reported prevalence of ST varies across the literature, ranging from 16.0% to 23.0% of all tinnitus cases. Moreover, among patients with ST, approximately 43.0% present with a cervical origin. The patients described in this study are representative of ST, particularly in the specific context of cochlear implant recipients. These patients underwent cochlear implantation following sudden sensorineural hearing loss and subsequently developed ST 1 year after the onset of hearing loss. Adjustments to cochlear implant sound processing parameters did not result in symptom improvement; however, the patients experienced clear clinical benefits following cervical spine physiotherapy. The therapeutic approach adopted yielded noteworthy outcomes. The interaction between the auditory system and the cervical spine highlights the importance of a multidisciplinary management strategy addressing both musculoskeletal and auditory health.