Non-Penetrating Round Window Electrode Stimulation for Tinnitus Therapy Followed by Cochlear Implant

[OptimusPrimed]

1: Wenzel GI, Sarnes P, Warnecke A, Stöver T, Jäger B, Lesinski-Schiedat A,
Lenarz T. Non-penetrating round window electrode stimulation for tinnitus therapy
followed by cochlear implantation. Eur Arch Otorhinolaryngol. 2014 Dec 6. [Epub
ahead of print] PubMed PMID: 25480476.


Abstract: One main theory behind the origin of tinnitus is based on the idea that alterations of the spontaneous electrical activity within the auditory system lead to abnormal firing patterns in the affected nervous structures [1]. A possible therapeutic option is the use of electrical stimulation of the auditory nerve for the recovery or at least limitation of the abnormal firing pattern to a level that can be easily tolerated by the patient. The Tinnelec Implant consists of a single non-penetrating stimulation electrode connected to a Neurelec cochlear implant system. As a first feasibility study, before starting implantations in hearing patients, we thought to assess the potential of the Tinnelec stimulation to treat tinnitus in unilateral deaf patients, analysing hereby its effectivity and risks. Three patients suffering from unilateral tinnitus resistant to pharmacological treatment and ipsilateral severe to profound sensorineural hearing loss/deafness were implanted with a Tinnelec system between September 2007 and July 2008, at the ENT Department of Hannover Medical School. The stimulation strategy was chosen to induce alleviation of the tinnitus through suppression, masking and/or habituation and the response of each patient on the treatment was monitored using a visual analogue scale (VAS) on loudness and annoyance of tinnitus, mood of the patient, as well as the tinnitus handicap inventory (THI). All patients had a benefit from the electrical stimulation for their tinnitus (THI-score improvement of 20-70), however, not all participants profited from the Tinnelec system in same way and degree. In one patient, despite good results, the device had to be replaced with a conventional cochlear implant because of Tinnelec-independent increase in hearing loss on the contralateral ear. Additionally, due to the extension of cochlear implant indications, the devices of the other two patients have been meanwhile replaced with a conventional cochlear implant to benefit additionally from hearing improvement. As demonstrated in the present study, sensorineural tinnitus in humans may be suppressed/masked/habituated by electrical stimulation. The main advantage of the Tinnelec implant would be the option to treat patients with normal and usable hearing, stimulating the affected ear with the cochlear non-penetrating stimulation electrode of the device, and extend the treatment in cases of progressive hearing loss by explanation and reimplantation with a penetrating electrode addressing tinnitus as well as the hearing impairment. The present study is the first report on a long-term follow-up on tinnitus patients implanted with Tinnelec. Further clinical studies to implant tinnitus patients with residual or normal hearing on the affected ear are on the way.

 

[NiNyu]

Any news?

 

[sakrt]

All "theories" abstracts for grant-funding and publicity. MANY other less invasive alternatives. Beware of surgeons as most do NOT have empathy. Surgeons such as Oto-neurologists rely on making a name for themselves through research by publications/abstracts, grant-funding and think they are above everyone else. Physicians or MDs seem to evaluate patients more thoroughly and do not compulsively jump to surgery as the only answer.
I am PROOF and it destroyed my life with 20x increase of 24 hr debilitating vibrating tinnitus and all HEARING GONE. I now cannot hear anyone, no music, NOTHING except this roaring hum electrical vibrating 24 hrs day and night. I cry every day and really, truly try to see some beauty in life visually in order to continue on, but it's a matter of time when I will leave life to escape this hell. You want to go that route to find out, you're more than welcome but don't say I didn't warn you. Cochlear Implants are NOT for tinnitus or hyperacusis but for those who cannot benefit from wearing hearing-aids to HEAR some sound which VARIES for every individual.
The End.

 

[Frédéric]

Development of a novel middle-ear electrode for tinnitus suppression – proof of concept
https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0039-1686479

Tinnitus is a phantom sound without external source. In Germany, round 10 million people are impaired by tinnitus. Intriguingly, hearing-impaired patients with cochlear implant often report reduction of their tinnitus following the implantation. Such reduction is presumably not only due to recovery of patients' hearing abilities but also due to the electrical stimulation. However, electrical stimulation therapy is not available for tinnitus patients without hearing loss.

The aim of our project is to determine the individual tinnitus suppression parameters to be used in clinical trials as well as to establish an animal model for testing the new middle ear tinnitus-suppressing electrodes.

The clinical part uses a routine clinical diagnostic step prior to cochlear implantation, namely stimulation via external ear canal. The already implanted patients can be stimulated directly via their cochlear electrode. The efficiency of stimulation (duration approximately two minutes), is determined by collecting several tinnitus parameters bevor, during, and after the stimulation. The patients react in a various ways by a temporary tinnitus suppression during and/or after the electrical stimulation.

In addition, the focus of preclinical study is on determining the shape, size and flexibility of new electrodes. For the first implantation tests, polyimide based electrode carrier are used. Guinea pig are used as an animal model to determine the performance of the tinnitus-suppressing implants.

Dr. rer nat Uta Reich
Klinik für HNO-Heilkunde der Charite Berlin,
Charitéplatz 1, 10117
Berlin
Email: u.reich@charite.de