Cochlear Implants as a Treatment of Tinnitus

It is true. You clearly don’t know what you’re talking about.

I have seen scientific studies and comments from people with cochlear implants who say it has eliminated their tinnitus; not just mask it.

 

No I won't. At some point, the music stops, or you remove your tinnitus masker, and due to the music/masking, your tinnitus might sound more aggressive for several hours when exposed to silence (in my case at least.) The cochlear implant doesn't come off, your tinnitus remains perpetually masked, even for decades until a cure is out while you study, pursue a career, do normal things etc.

 

You're in luck. It was discussed in detail by the scientist that made tinnitus disappear by directly stimulating the cochlea in this Tinnitus Talk Podcast:

→ Episode 20: The Man Who Donated a Million Dollars to Tinnitus Research

 

No one with tinnitus would knowingly have a cochlear implant in the hope it might help their tinnitus. This is not what that is for at all.

 

Perhaps you're right, we're supposed to be docile and suffer indefinitely, take verbal abuse from acquaintances, and think about suicide. No one with tinnitus would prefer a cochlear implant to suicide?

 

I think the questions are:

Would cochlear implants benefit someone with normal audiogram? No.

Mild hearing loss? No.

Moderate hearing loss? Maybe.

Severe-profound hearing loss? Probably.

But what if you only have severe-profound hearing loss in the high frequencies (4000 Hz - 8000 Hz? Or 1000 Hz - 4000 Hz? Or in the low frequencies of 250 Hz - 1000 Hz?

From a tinnitus point of view we don't know because cochlear implants are administered on not tinnitus or just audiograms, but speech-in-noise tests and all sorts.

I have unilaterally severe-profound hearing loss from 4000 Hz - 8000 Hz. I would never qualify on the hearing aspect and I may lose everything below 3000 Hz. But would cochlear implants help severe reactive tinnitus? It's a minefield.

 

I would especially as it seems one side may impact tinnitus on all sides. I could live much better and happier with one natural ear with no tinnitus than two with an endless screech.

 

@Piney, what if you have severe/profound single-sided hearing loss from 4000 Hz to 8000 Hz with severe tinnitus?

 

In my case a team of audiologists and a surgeon determined it by case of severeness and word discrimination, including how it affects your quality of life. I had a hard time hearing with my good ear over the tinnitus etc. It’s a tough decision but I had nothing to lose.

When not using my processor, it will escalate over 2 days to awful levels.

My tinnitus is still not totally gone, but after 6 months I can sit in a quiet space and not notice it.

There is no headset that’s going to fix tinnitus. It has to be a drug, surgery, or some serious electrical current in my opinion.

My cochlear implant is awful in wind and loud echo-y restaurants and rooms. Keep that in mind.

 

What does it sound like when you use the cochlear implant? I always imagine things being robotic sounding.

 

Thanks for your advice @Piney. For hearing alone, my audiogram is bad enough. Normal hearing from 250 Hz - 3000 Hz. The tinnitus is debilitating though. I've looked at hybrids...

Maybe I should wait for the Michigan device and see if it brings it down a touch.

By headset, do you mean what?

 

Actually people do who fit the criteria.

 

Going in for my cochlear implant evaluation in about 3 hours. I understand that voices sound more natural within days/weeks/months. Highly variable.

 

Yes, that’s what I’ve heard. Your brain adjusts. It takes practice.

 

Good on you. If anything, the dramatic failure of these hyped up hearing regeneration drugs has at least made you make a positive decision. There will be NOTHING in the next 10, probably 15 years.

 

For single-sided deafness, with one great ear, it is robotic, but close enough with certain frequencies. It will never be full original hearing but it definitely fills gaps since after surgery you’re most likely fully deaf. It does work for sure.

 

Incredible.

 

Cochlear Implantation Outcomes in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis

 

Cochlear implantation in single-sided deafness: a single-center experience of 138 cases

Conclusions: To the best of our knowledge, this paper descried the largest cohort of SSD who underwent CI in a single institution. According to our findings CI in patients affected by SSD represents a valuable tool for an overall improvement of tinnitus and dizziness but also quality of life, after at least 6 months of follow-up. Further studies are desirable to improve rehabilitation pathways and possibly set new standards of care of this condition.

 

So is this good or bad, or both?

I'm not liking the "further studies" added on in at the end. I feel by now they should have had all the kinks worked out Like come on, what are we doing here? Or maybe I'm reading this entirely wrong and this is a victory...

What's your conclusion @Nick47?

 

Basically generally good news. Single-sided deafness treated with a cochlear implant reduces or eliminates tinnitus in around 80% of cases. This is just a single centre summary. It's only a pre-print so we don't know the details.

 

A 2015 review:

A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant

@Fightthearmy, this seems to be the issue of why it's not expanded to more people with hearing loss/tinnitus.

How do you preserve more residual hearing? Hybrids? Surgical techniques? Medications?

If they supplemented hearing rather than replaced, then it's a game changer.

 

Tinnitus suppression in a prospective cohort of 45 cochlear implant recipients: occurrence, degree and correlates

Conclusion: 64% of the patients with SNHL had pre-implant tinnitus, which was decreased 4 and 14 months after implantation. Overall, 68% of patients with tinnitus improved their tinnitus handicap after CI. Patients with higher THI and VAS scores had a larger decline and the highest benefits in terms of tinnitus handicap improvement. The study findings demonstrate that the majority of patients with moderate to profound SNHL eligible for cochlear implantation benefit from complete or partial tinnitus suppression and improved quality of life after implantation.

 

I’m guessing this is only effective if your tinnitus is caused or exacerbated by hearing loss. Those of us with ‘perfect hearing’ wouldn’t benefit from a cochlear implant?

 

Cochlear implants really seem to be the only "device" shown to be able to reduce or even eliminate tinnitus.

If only the mechanism was better understood, and which patients would benefit (which the data of all these case studies must show in some manner), this may be a feasible treatment for some types of tinnitus.

I'm sure many, especially on here, would trade their natural hearing for tinnitus suppression.

 

In the future, maybe you won't need to trade off - this newly formed startup are working on an implant that stimulates the outside of the cochlea to restore high frequencies without damaging residual hearing:

• Stanford University: Extracochlear neurostimulation - Auricle
• Y Combinator: Auricle
• Auricle Website

Currently in funding stage and developing an implant for clinical trials. No mention of tinnitus so far, but worth following I think.

 

Yes, you would need at least moderate hearing loss between 250 Hz - 8000 Hz. Anything beyond 8000 Hz is not classed as hearing loss as many people (but not all) have significant drops after 8000 Hz after the age of 40 as part of normal age-related hearing loss.

More severe hearing loss, shorter durations of deafness and single-sided deafness are good predictors.

Useful.

 

This has been on my mind the last few days. If higher frequency hearing loss can create tinnitus, then should an extended audiogram be done in terms of SSNHL? I know @ErikaS reported her situation as such, so in which cases should the standard procedure of steroid intervention be followed?

My GP suspected SSNHL when this spike started. He only did a Rinne and Weber test which indicated it. I had some duller hearing and was very sensitive to higher frequencies. I was given a steroid course and seen 2 weeks later by the ENT team. I do think my hearing recovered despite the new tinnitus still being present.

The Rinne and Weber test showed sensorineural hearing loss but I was given two audiograms and both came back with perfect hearing.

 

I had just turned 33 three months before the ear infection came on. It did in fact go into my inner ear and cause damage. I wish I was 40+ when I got this, because maybe those frequencies would have already been gone and my cochlea-auditory nerve-brain wouldn’t have given a shit and nothing come from it. But I instantly got ultra high-frequency tinnitus that fell in the 12.5 kHz area. Eventually when I had an extended audiogram, it showed a dramatic dip starting at 12.5 kHz in my right ear and going to 16 kHz and the worst it dipped to was 60 dB. That was not at all the case with my left. The left ear was still hearing up to 16 kHz very well. So that audiologist at the University of Pittsburgh told me I experienced sudden hearing loss/damage from the infection in my right ear given my onset presentation and ongoing / worsening tinnitus, not to mention reactivity and sound distortions.

I wish it was caught at onset because I would have wanted the opportunity to see if high dose steroids and/or steroid shots could have mitigated my situation in any way, or at least prevented it from getting as bad as it did. Even if not, at least I would have had the opportunity.

Given my unique situation, I don’t even know if these devices would work. What I quietly hope is, once my left ear naturally loses those high frequencies, that at least both ears will be equal again and maybe something magical could happen with a reset.

 

No point in them doing an extended audiogram.

1) Hearing aids work up to 8000 Hz at best.
2) Most people over 30-40 have hearing loss on an extended audiogram.
3) Cochlear implants go up to 8000 Hz.