Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China.
Shanghai Clinical Medical Center of Hearing Medicine, Shanghai 200031, China.
Neural Plast. 2021 Jun 24;2021:6678863. doi: 10.1155/2021/6678863. eCollection 2021.
Patients with profound bilateral deafness (BD) are prone to suffering from tinnitus, which further leads to psychological comorbidities and makes it more difficult for patients to communicate with people. This study was aimed at investigating the effect of cochlear implants (CIs) on tinnitus distress and psychological comorbidities in patients with profound BD. This multicenter retrospective study reviewed 51 patients with severe postlingual BD who underwent cochlear implantation; 49 patients underwent unilateral cochlear implantation, and 2 patients underwent bilateral cochlear implantation. The patients were asked to complete all the questionnaires, including the tinnitus handicap inventory (THI), the visual analog scale (VAS) score, the Hospital Anxiety and Depression Scale Questionnaire (HADS), the Categories of Auditory Performance (CAP), and the Speech Intelligibility Rating (SIR), at least 4 months after implantation when the CI was on or off, in approximately May-June 2019. In our study, 94% (48/51) of BD patients suffered from tinnitus before CI, and 77% (37/48) of them suffered from bilateral tinnitus. In addition, 50.9% (26/51) of the CI patients were suffering from anxiety, 52.9% (27/51) of them were suffering from depression (score ≥ 8), and 66.7% (34/51) (27/51) of them were suffering from anxiety or depression. Cochlear implantation could reduce tinnitus more obviously when the CI was on than when the CI was off. Cochlear implantation also reduced anxiety/depression severity. There were significantly positive correlations between tinnitus severity and anxiety/depression severity before and after surgery. Moreover, hearing improvement is positively correlated with reduction level of tinnitus, the better hearing, and the lesser severity of tinnitus. Thus, along with effective restoration of deafferentation, cochlear implantation shows positive therapeutic effects on tinnitus and psychological comorbidities, providing a reference for future clinical and research work.
患者患有严重双侧耳聋（BD），容易遭受耳鸣困扰，进一步导致心理合并症，使患者更难以与他人交流。本研究旨在探讨人工耳蜗植入（CI）对严重后天性 BD 患者耳鸣困扰和心理合并症的影响。这项多中心回顾性研究共纳入 51 例接受人工耳蜗植入的严重后天性 BD 患者；其中 49 例患者接受单侧人工耳蜗植入，2 例患者接受双侧人工耳蜗植入。患者在植入后至少 4 个月（大约在 2019 年 5 月至 6 月），当 CI 开启或关闭时，完成所有问卷，包括耳鸣残疾量表（THI）、视觉模拟量表（VAS）评分、医院焦虑抑郁量表问卷（HADS）、听觉能力分类量表（CAP）和言语可懂度分级（SIR）。在我们的研究中，94%（48/51）的 BD 患者在 CI 前患有耳鸣，77%（37/48）的患者患有双侧耳鸣。此外，50.9%（26/51）的 CI 患者患有焦虑症，52.9%（27/51）的患者患有抑郁症（得分≥8），66.7%（34/51）的患者患有焦虑或抑郁症。与 CI 关闭相比，CI 开启时耳鸣减轻更明显。CI 还降低了焦虑/抑郁的严重程度。手术前后，耳鸣严重程度与焦虑/抑郁严重程度之间存在显著的正相关。此外，听力改善与耳鸣减轻水平呈正相关，听力越好，耳鸣越轻。因此，人工耳蜗植入除了能有效地恢复去传入外，对耳鸣和心理合并症也有积极的治疗效果，为今后的临床和研究工作提供了参考。
