Knopke Steffen, Szczepek Agnieszka J, Häussler Sophia Marie, Gräbel Stefan, Olze Heidi
Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Hospital Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Hospital Berlin, Campus Charité Mitte, Berlin, Germany.
Front Neurol. 2017 Apr 25;8:158. doi: 10.3389/fneur.2017.00158. eCollection 2017.
Tinnitus is a common symptom of hearing impairment. Patients who are bilaterally hard of hearing are often affected by tinnitus. However, they cannot undergo any of the standard tinnitus therapies, since they rely on hearing. Cochlear implantation (CI) used to treat severe hearing disabilities, such as bilateral hearing loss, was also shown to reduce tinnitus. Our goal was to determine if CI induces sustained reduction of tinnitus. We performed prospective, longitudinal analyses of tinnitus-related distress in a uniform group of bilaterally deafened patients after CI.
The homogenous sample consisted of 41 patients who met the inclusion criteria and were consecutively included in this study. The impact of unilateral CI on tinnitus-related distress, health-related quality of life (HRQoL), and hearing abilities was studied with validated instruments. The follow-up appointments were scheduled at 6, 12, and 24 months after CI surgery. During the appointments, hearing abilities were estimated with monosyllabic Freiburg test, whereas the tinnitus-related distress, the HRQoL, and the subjective hearing were measured with standard questionnaires [Tinnitus Questionnaire (TQ), Nijmegen Cochlear Implantation Questionnaire, and Oldenburg Inventory, respectively].
Tinnitus-related distress decreased significantly from the mean TQ score of 35.0 (SD = 19.6) prior to surgery to the mean TQ = 27.54 (SD = 20.0) 6 months after surgery and remained sustained low until the end of follow-up period. In addition, CI significantly improved the hearing abilities and the HRQoL of all patients.
The results from our prospective study suggest that in a homogenous sample of bilaterally deafened, implanted patients who report having tinnitus prior to surgery, CI alone not only improves the hearing abilities but also significantly reduces the tinnitus-related distress and improves the HRQoL in a sustained way.
耳鸣是听力障碍的常见症状。双侧听力减退的患者常受耳鸣困扰。然而,由于他们依赖听力,无法接受任何标准的耳鸣治疗。用于治疗严重听力残疾(如双侧听力丧失)的人工耳蜗植入(CI)也被证明可减轻耳鸣。我们的目标是确定人工耳蜗植入是否能使耳鸣持续减轻。我们对一组接受人工耳蜗植入的双侧失聪患者进行了与耳鸣相关痛苦的前瞻性纵向分析。
同质样本包括41名符合纳入标准并连续纳入本研究的患者。使用经过验证的工具研究单侧人工耳蜗植入对耳鸣相关痛苦、健康相关生活质量(HRQoL)和听力能力的影响。随访预约安排在人工耳蜗植入手术后6、12和24个月。在预约期间,用单音节弗莱堡测试评估听力能力,而分别用标准问卷[耳鸣问卷(TQ)、奈梅亨人工耳蜗植入问卷和奥尔登堡量表]测量耳鸣相关痛苦、HRQoL和主观听力。
耳鸣相关痛苦从术前平均TQ评分35.0(标准差=19.6)显著降至术后6个月的平均TQ = 27.54(标准差=20.0),并在随访期结束前一直保持在低水平。此外,人工耳蜗植入显著改善了所有患者的听力能力和HRQoL。
我们前瞻性研究的结果表明,在术前报告有耳鸣的双侧失聪植入患者的同质样本中,单独的人工耳蜗植入不仅能改善听力能力,还能显著减轻耳鸣相关痛苦,并持续改善HRQoL。