Ramos Macías Angel, Falcón González Juan Carlos, Manrique Manuel, Morera Constantino, García-Ibáñez Luis, Cenjor Carlos, Coudert-Koall Chrystellel, Killian Matthijs
Unidad de Hipoacusia, Servicio de Otorrinolaringología, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas, Spain.
Audiol Neurootol. 2015;20 Suppl 1:60-6. doi: 10.1159/000380750. Epub 2015 May 19.
Tinnitus is an incapacitating condition commonly affecting cochlear implant (CI) candidates. The aim of this clinical study is to assess the long-term effects of CI treatment in patients with severe-to-profound, sensorineural, unilateral hearing loss (UHL) and incapacitating tinnitus. We performed a prospective Cochlear™ company-sponsored multicentre study in five Spanish centres. Sixteen patients with UHL and incapacitating tinnitus, which was indicated by a Tinnitus Handicap Inventory (THI) score >58%, received a Nucleus® CI in their deaf ear. The study design includes repeated within-subject measures on hearing, tinnitus, hyperacusis and quality of life up to 12 months after initial CI fitting. In addition to hearing loss and tinnitus, all patients suffered from hyperacusis. Most patients had a sudden hearing loss and received a CI within 2 years after their hearing loss. Preliminary 6-month, post-CI activation data of 13 subjects showed that the majority of patients perceived a subjective benefit from CI treatment, which was assessed using the THI, a Visual Analogue Scale of tinnitus loudness/annoyance and the Speech, Spatial and Qualities of Hearing Scale. Preliminary 12-month data of 7 subjects showed that most patients also perceived a degree of relief from their hyperacusis. One patient showed no improvements in any of the applied scales, which could be explained by partial insertion of the electrode due to obstruction of the cochlea by otosclerosis. In conclusion, CI can successfully be used in the treatment of UHL patients with accompanying severe tinnitus and hyperacusis. Implantation resulted in hearing benefits and a durable relief from tinnitus and hyperacusis in the majority of patients. These findings support the hypothesis that pathophysiological mechanisms after peripheral sensorineural hearing loss are at least partly reversible when hearing is restored with a CI.
耳鸣是一种使人丧失能力的病症，通常会影响人工耳蜗（CI）植入候选者。这项临床研究的目的是评估CI治疗对重度至极重度感音神经性单侧听力损失（UHL）且伴有使人丧失能力的耳鸣患者的长期影响。我们在西班牙的五个中心进行了一项由科利耳公司赞助的前瞻性多中心研究。16例UHL且伴有使人丧失能力的耳鸣患者（耳鸣障碍量表[THI]评分>58%表明存在该情况）在其患侧耳聋耳植入了Nucleus® CI。研究设计包括在初次CI植入后长达12个月内对听力、耳鸣、听觉过敏和生活质量进行重复的受试者内测量。除听力损失和耳鸣外，所有患者均患有听觉过敏。大多数患者突发听力损失，并在听力损失后2年内接受了CI植入。13名受试者CI激活后6个月的初步数据显示，大多数患者从CI治疗中获得了主观益处，这是使用THI、耳鸣响度/烦恼视觉模拟量表以及言语、空间和听力质量量表进行评估的。7名受试者12个月的初步数据显示，大多数患者的听觉过敏也有一定程度的缓解。1例患者在任何应用量表上均未显示改善，这可能是由于耳硬化症导致耳蜗阻塞，电极部分插入所致。总之，CI可成功用于治疗伴有严重耳鸣和听觉过敏的UHL患者。植入使大多数患者听力受益，并持久缓解耳鸣和听觉过敏。这些发现支持了这样一种假设，即当通过CI恢复听力时，外周感音神经性听力损失后的病理生理机制至少部分是可逆的。
