(PP807) Reduction in Tinnitus Severity for Adult Cochlear Implant Recipients

For adult CI candidates who report tinnitus prior to implantation, most experience tinnitus reduction/suppression with the CI on and some also report reduction/suppression with the CI off. Little is known about the range of tinnitus severity postoperatively with the device on/off for CI recipients and whether it is associated with preoperative severity. The present report evaluated tinnitus severity in adult CI candidates at the preoperative evaluation and at post-activation visits in order to characterize preoperative and post-activation tinnitus severity in adult CI users.

Summary: 

Adult patients with moderate-to-profound often report the presence of tinnitus. For those who meet cochlear implantation candidacy criteria and receive a cochlear implant (CI), the tinnitus is reportedly reduced/suppressed when the CI is on. For some, the tinnitus is also reduced/suppressed with the CI is off. Rarely, the severity of the tinnitus reportedly increases after implantation. Little is known about the range of tinnitus severity for CI recipients postoperatively with the device on versus off and whether it is associated with preoperative severity. The present report aimed to characterize preoperative and post-activation tinnitus severity for adult CI recipients to improve the counseling for patients with tinnitus who are pursuing cochlear implantation.

DESIGNS: The Tinnitus Handicap Inventory (THI) was administered to adult patients at the cochlear implantation candidacy evaluation (baseline) and at post-activation intervals. Participants were asked to respond with their perceptions of their tinnitus severity with a device on (preoperative: hearing aid, post-activation: CI) versus off. Post-activation intervals included the 1-month, 3-month, and 6-month visits. Post-activation performance was compared to the preoperative perceptions and to the previous visit to determine the time course for changes in tinnitus severity when the CI was on versus off.

Results: Tinnitus severity at the preoperative interval in this sample ranged from slight to catastrophic, with the majority reporting moderate tinnitus severity. As expected, a significant reduction in tinnitus severity was observed after introduction of the CI – with the largest difference observed at the 1-month interval. The reduction/suppression of the tinnitus with the CI on was stable across the 1-month and 6-month intervals. Tinnitus severity was poorer with the CI off, though reduced as compared to preoperative perceptions. There was no significant association with preoperative and post-activation tinnitus severity, though this may have been limited by floor effects.

Conclusion: Adult CI users experience a significant reduction/suppression of their tinnitus in the implanted ear with the CI on and off as compared to their preoperative perceptions. While the majority experience this benefit, it is not experienced by all CI recipients. The present data are intended to support better counseling of CI candidates who also present with tinnitus on the realistic expectations for the post-activation period.